EP4217389A1 - Anti-sclerostin constructs and uses thereof - Google Patents

Anti-sclerostin constructs and uses thereof

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Publication number
EP4217389A1
EP4217389A1 EP21871631.4A EP21871631A EP4217389A1 EP 4217389 A1 EP4217389 A1 EP 4217389A1 EP 21871631 A EP21871631 A EP 21871631A EP 4217389 A1 EP4217389 A1 EP 4217389A1
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EP
European Patent Office
Prior art keywords
amino acid
seq
acid sequence
sclerostin
cdr3
Prior art date
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Pending
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EP21871631.4A
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German (de)
English (en)
French (fr)
Inventor
Xiaofeng Liu
Kunfeng LIU
Baozhi Yuan
Muyu LI
Huazhu Ke
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Angitia Inc Ltd
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Angitia Biomedicines Ltd
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Application filed by Angitia Biomedicines Ltd filed Critical Angitia Biomedicines Ltd
Publication of EP4217389A1 publication Critical patent/EP4217389A1/en
Pending legal-status Critical Current

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    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K16/00—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies
    • C07K16/18—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans
    • C07K16/22—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against growth factors ; against growth regulators
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K16/00—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies
    • C07K16/46—Hybrid immunoglobulins
    • C07K16/468—Immunoglobulins having two or more different antigen binding sites, e.g. multifunctional antibodies
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P19/00—Drugs for skeletal disorders
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P19/00—Drugs for skeletal disorders
    • A61P19/08—Drugs for skeletal disorders for bone diseases, e.g. rachitism, Paget's disease
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P19/00—Drugs for skeletal disorders
    • A61P19/08—Drugs for skeletal disorders for bone diseases, e.g. rachitism, Paget's disease
    • A61P19/10—Drugs for skeletal disorders for bone diseases, e.g. rachitism, Paget's disease for osteoporosis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P21/00—Drugs for disorders of the muscular or neuromuscular system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P35/00—Antineoplastic agents
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K16/00—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies
    • C07K16/18—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K16/00—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies
    • C07K16/18—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans
    • C07K16/28—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants
    • C07K16/2875—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants against the NGF/TNF superfamily, e.g. CD70, CD95L, CD153, CD154
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K39/00—Medicinal preparations containing antigens or antibodies
    • A61K2039/505—Medicinal preparations containing antigens or antibodies comprising antibodies
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K2317/00—Immunoglobulins specific features
    • C07K2317/20—Immunoglobulins specific features characterized by taxonomic origin
    • C07K2317/24—Immunoglobulins specific features characterized by taxonomic origin containing regions, domains or residues from different species, e.g. chimeric, humanized or veneered
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K2317/00—Immunoglobulins specific features
    • C07K2317/30—Immunoglobulins specific features characterized by aspects of specificity or valency
    • C07K2317/31—Immunoglobulins specific features characterized by aspects of specificity or valency multispecific
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K2317/00—Immunoglobulins specific features
    • C07K2317/30—Immunoglobulins specific features characterized by aspects of specificity or valency
    • C07K2317/33—Crossreactivity, e.g. for species or epitope, or lack of said crossreactivity
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K2317/00—Immunoglobulins specific features
    • C07K2317/30—Immunoglobulins specific features characterized by aspects of specificity or valency
    • C07K2317/34—Identification of a linear epitope shorter than 20 amino acid residues or of a conformational epitope defined by amino acid residues
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K2317/00—Immunoglobulins specific features
    • C07K2317/50—Immunoglobulins specific features characterized by immunoglobulin fragments
    • C07K2317/52—Constant or Fc region; Isotype
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K2317/00—Immunoglobulins specific features
    • C07K2317/50—Immunoglobulins specific features characterized by immunoglobulin fragments
    • C07K2317/55—Fab or Fab'
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K2317/00—Immunoglobulins specific features
    • C07K2317/50—Immunoglobulins specific features characterized by immunoglobulin fragments
    • C07K2317/56—Immunoglobulins specific features characterized by immunoglobulin fragments variable (Fv) region, i.e. VH and/or VL
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K2317/00—Immunoglobulins specific features
    • C07K2317/50—Immunoglobulins specific features characterized by immunoglobulin fragments
    • C07K2317/56—Immunoglobulins specific features characterized by immunoglobulin fragments variable (Fv) region, i.e. VH and/or VL
    • C07K2317/565—Complementarity determining region [CDR]
    • C—CHEMISTRY; METALLURGY
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    • C07K2317/00—Immunoglobulins specific features
    • C07K2317/60—Immunoglobulins specific features characterized by non-natural combinations of immunoglobulin fragments
    • C07K2317/62—Immunoglobulins specific features characterized by non-natural combinations of immunoglobulin fragments comprising only variable region components
    • C07K2317/622—Single chain antibody (scFv)
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K2317/00—Immunoglobulins specific features
    • C07K2317/70—Immunoglobulins specific features characterized by effect upon binding to a cell or to an antigen
    • C07K2317/76—Antagonist effect on antigen, e.g. neutralization or inhibition of binding
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K2317/00—Immunoglobulins specific features
    • C07K2317/90—Immunoglobulins specific features characterized by (pharmaco)kinetic aspects or by stability of the immunoglobulin
    • C07K2317/92—Affinity (KD), association rate (Ka), dissociation rate (Kd) or EC50 value
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K2317/00—Immunoglobulins specific features
    • C07K2317/90—Immunoglobulins specific features characterized by (pharmaco)kinetic aspects or by stability of the immunoglobulin
    • C07K2317/94—Stability, e.g. half-life, pH, temperature or enzyme-resistance
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K2319/00—Fusion polypeptide
    • C07K2319/30—Non-immunoglobulin-derived peptide or protein having an immunoglobulin constant or Fc region, or a fragment thereof, attached thereto

Definitions

  • the present disclosure relates to anti-Sclerostin constructs (such as anti-Sclerostin antibodies) and the uses thereof.
  • the present application in one aspect provides anti-Sclerostin constructs comprising an antibody moiety that specifically recognizes Sclerostin (such as human Sclerostin) comprising a heavy chain variable region (V H ) and a light chain variable region (V L ) , such as any of the anti-Sclerostin constructs described herein.
  • Sclerostin such as human Sclerostin
  • V H heavy chain variable region
  • V L light chain variable region
  • the present application in another aspect provides anti-Sclerostin constructs comprising an antibody moiety that specifically recognizes Sclerostin (such as human Sclerostin) , and a second moiety.
  • the second moiety comprises a half-life extending moiety (such as an Fc fragment) .
  • the second moiety comprises an agent selected from the group consisting of a parathyroid hormone (PTH) , a selective estrogen receptor modulator (SERM) , a bisphosphonate, prostaglandin E (PGE) receptor agonists, Vascular endothelial growth factor (VEGF) , transforming growth factor- ⁇ (TGF ⁇ ) , growth factor (myostatin) and calcitonin.
  • PTH parathyroid hormone
  • SERM selective estrogen receptor modulator
  • PGE prostaglandin E
  • VEGF Vascular endothelial growth factor
  • TGF ⁇ transforming growth factor- ⁇
  • growth factor myostatin
  • the second moiety comprises a second antibody moiety that specifically recognizes an antigen.
  • anti-Sclerostin constructs comprising a first antibody moiety that specifically recognizes Sclerostin (including but not limited to anti-Sclerostin antibody moieties described herein) , and a second antibody moiety that specifically recognizes Dickkopf-1 (DKK1) or receptor activator of nuclear factor kappa beta ligand (RANKL) .
  • DKK1 or RANKL can be any anti-DKK1 antibody moiety or anti-RANKL antibody moiety (including but not limited to those described herein) .
  • the second antibody moiety is a full-length antibody, a Fab, a Fab’, a (Fab’) 2 , an Fv, a single chain Fv (scFv) fragment, a scFv-scFv, a minibody, a diabody, or an sdAb.
  • the second antibody moiety is a full-length antibody comprising an Fc fragment, and wherein the anti-Sclerostin antibody moiety is a single chain Fv (scFv) fragment.
  • the second antibody moiety is a scFv fragment, and wherein the anti-Sclerostin antibody moiety is a full-length antibody comprising an Fc fragment.
  • the scFv fragment is fused to (e.g., N-terminus and/or C-terminus of) both of the heavy chains and/or light chains of the full-length antibody (via a linker or without a linker) .
  • the construct comprises: a) a first polypeptide comprising a first light chain comprising, from N-terminus to C-terminus, i) the V L , ii) a first light chain constant domain ( “first CL domain” ) ; b) a second polypeptide comprising a first heavy chain comprising, from N-terminus to C-terminus, i) the V H , ii) a first heavy chain constant domain ( “first CH1 domain” ) , and iii) a first Fc domain; c) a third polypeptide comprising a second heavy chain comprising, from N-terminus to C-terminus, i) the V H-2 , ii) a second heavy chain constant domain ( “second CH1 domain” ) , and iii) a second Fc domain; and d) a fourth polypeptide comprising a second light chain comprising, from N-terminus to C-terminus, i) the V L-2 ,
  • the present application in another aspect provides anti-Sclerostin constructs that specifically bind to Sclerostin competitively with any of the anti-Sclerostin constructs described herein.
  • compositions comprising any of the anti-Sclerostin constructs described herein and a pharmaceutically acceptable carrier.
  • the composition further comprises an agent selected from the group consisting of a parathyroid hormone (PTH) , a selective estrogen receptor modulator (SERM) , VEGF, TGF ⁇ , growth factor (myostatin) and calcitonin.
  • PTH parathyroid hormone
  • SERM selective estrogen receptor modulator
  • VEGF vascular endothelial growth factor
  • TGF ⁇ growth factor
  • myostatin growth factor
  • calcitonin calcitonin.
  • the present application in another aspect provides isolated nucleic acids encoding any of the anti-Sclerostin constructs described herein or a portion thereof (e.g., one or more polypeptides thereof) .
  • the present application in another aspect provides vectors comprising any of the isolated nucleic acids described herein.
  • the present application in another aspect provides isolated host cells comprising any of the isolated nucleic acids and/or any of the vectors described herein.
  • the present application in another aspect provides methods of producing an anti-Sclerostin construct comprising: a) culturing any of the isolated host cells described herein under conditions effective to express the anti-Sclerostin construct or a portion thereof (e.g., one or more polypeptides thereof) ; and b) obtaining the expressed anti-Sclerostin construct or a portion thereof from the host cells.
  • the present application in another aspect provides methods of treating a disease or condition in an individual, comprising administering to the individual an effective mount of an anti-Sclerostin construct such as any of the anti-Sclerostin constructs described herein, or any of the pharmaceutical compositions described herein.
  • the disease or condition is a bone-related disorder.
  • the bone-related disorder is osteogenesis imperfecta, osteopetrosis, osteoporosis (in men and/or women) , senile osteoporosis, delay bone healing, delayed or non-union bone fractures, Paget’s disease, immobilization-induced bone loss, glucocorticoid-induced bone loss, inflammation-induced bone loss including arthritis-induced bone loss or other disease or condition associated with a) bone loss of either quantity or quality or both and/or b) abnormality of bone structure and quality.
  • the anti-Sclerostin construct or the pharmaceutical composition is administered parenterally into the individual.
  • the method further comprises administering a second agent or therapy (e.g., an anti-DKK1 antibody or an anti-RANKL antibody) .
  • a second agent or therapy e.g., an anti-DKK1 antibody or an anti-RANKL antibody
  • the second agent or therapy comprises an agent selected from the group consisting of a parathyroid hormone (PTH) , a selective estrogen receptor modulator (SERM) , a bisphosphonate, a prostaglandin E (PGE) receptor agonist, VEGF, and TGF ⁇ , growth factor (myostatin) and calcitonin.
  • PTH parathyroid hormone
  • SERM selective estrogen receptor modulator
  • PGE prostaglandin E
  • VEGF vascular endothelial growth factor
  • TGF ⁇ growth factor (myostatin) and calcitonin.
  • the individual is a human.
  • FIG. 1 shows the sequences and conformation ‘IGRGKWWR’ motif on the second loop of Sclerostin to illustrate the interaction between Sclerostin and LDL Receptor Related Protein 6 (LRP6) .
  • FIG. 2 shows Sclerostin epitope mapping of monoclonal Ab (mAb) 93B1B7 using synthetic peptide fragments on the second loop of Sclerostin.
  • FIG. 3 shows that Romosozumab does not recognize peptides from the second loop of human Sclerostin bound by mAb 93B1B7.
  • FIG. 4 shows that 93B1B7 and Romosozumab occupy different Sclerostin epitopes and do not cross-block each other’s binding to sclerostin.
  • FIG. 5 shows schematic diagrams of exemplary bispecific antibody structures.
  • FIG. 6 shows results from BioLayer Interferometry (BLI) sensorgram that demonstrate the incremental binding of human Sclerostin and DKK1 to bispecific antibodies;
  • FIG. 7 shows serum concentrations of bispecific antibodies following 30mg/kg subcutaneous administration in cynomolgus monkeys.
  • the present application provides novel anti-Sclerostin constructs that specifically bind to Sclerostin (such as anti-Sclerostin monoclonal antibodies or multispecific antibodies) , methods of preparing the anti-Sclerostin constructs, methods of using the constructs (e.g., methods of treating a disease or condition) .
  • the exemplary anti-Sclerostin constructs described herein achieved advantageous effects.
  • exemplary anti-Sclerostin constructs exhibited higher binding affinity to Sclerostin as compared to Romosozumab. See Examples 3, 5, and 6 (Tables 5, 7, and 8) .
  • antibody is used in its broadest sense and encompasses various antibody structures, including but not limited to monoclonal antibodies, polyclonal antibodies, multispecific antibodies (e.g., bispecific antibodies) , full-length antibodies and antigen-binding fragments thereof, so long as they exhibit the desired antigen-binding activity.
  • antibody moiety refers to a full-length antibody or an antigen-binding fragment thereof.
  • a full-length antibody comprises two heavy chains and two light chains.
  • the variable regions of the light and heavy chains are responsible for antigen binding.
  • the variable domains of the heavy chain and light chain may be referred to as “V H ” and “V L ” , respectively.
  • the variable regions in both chains generally contain three highly variable loops called the complementarity determining regions (CDRs) (light chain (LC) CDRs including LC-CDR1, LC-CDR2, and LC-CDR3, heavy chain (HC) CDRs including HC-CDR1, HC-CDR2, and HC-CDR3) .
  • CDRs complementarity determining regions
  • CDR boundaries for the antibodies and antigen-binding fragments disclosed herein may be defined or identified by the conventions of Kabat, Chothia, or Al-Lazikani (Al-Lazikani 1997; Chothia 1985; Chothia 1987; Chothia 1989; Kabat 1987; Kabat 1991) .
  • the three CDRs of the heavy or light chains are interposed between flanking stretches known as framework regions (FRs) , which are more highly conserved than the CDRs and form a scaffold to support the hypervariable loops.
  • FRs framework regions
  • the constant regions of the heavy and light chains are not involved in antigen binding, but exhibit various effector functions.
  • Antibodies are assigned to classes based on the amino acid sequence of the constant region of their heavy chain.
  • the five major classes or isotypes of antibodies are IgA, IgD, IgE, IgG, and IgM, which are characterized by the presence of ⁇ , ⁇ , ⁇ , ⁇ , and ⁇ heavy chains, respectively.
  • Several of the major antibody classes are divided into subclasses such as lgG1 ( ⁇ 1 heavy chain) , lgG2 ( ⁇ 2 heavy chain) , lgG3 ( ⁇ 3 heavy chain) , lgG4 ( ⁇ 4 heavy chain) , lgA1 ( ⁇ 1 heavy chain) , or lgA2 ( ⁇ 2 heavy chain) .
  • antigen-binding fragment refers to an antibody fragment including, for example, a diabody, a Fab, a Fab’, a F (ab’) 2, an Fv fragment, a disulfide stabilized Fv fragment (dsFv) , a (dsFv) 2 , a bispecific dsFv (dsFv-dsFv’) , a disulfide stabilized diabody (ds diabody) , a single-chain Fv (scFv) , a dsscFv, an scFv dimer (bivalent diabody) , a multispecific antibody formed from a portion of an antibody comprising one or more CDRs, a camelized single domain antibody, a nanobody, a domain antibody, a bivalent domain antibody, or any other antibody fragment that binds to an antigen but does not comprise a complete antibody structure.
  • an antigen-binding fragment is capable of binding to the same antigen to which the parent antibody or a parent antibody fragment (e.g., a parent scFv) binds.
  • an antigen-binding fragment may comprise one or more CDRs from a particular human antibody grafted to a framework region from one or more different human antibodies.
  • “Fv” is the minimum antibody fragment, which contains a complete antigen-recognition and -binding site. This fragment consists of a dimer of one heavy-and one light-chain variable region domain in tight, non-covalent association. From the folding of these two domains emanate six hypervariable loops (3 loops each from the heavy and light chain) that contribute the amino acid residues for antigen binding and confer antigen binding specificity to the antibody. However, even a single variable domain (or half of an Fv comprising only three CDRs specific for an antigen) has the ability to recognize and bind antigen, although at a lower affinity than the entire binding site.
  • Single-chain Fv also abbreviated as “sFv” or “scFv, ” are antibody fragments that comprise the V H and V L antibody domains connected into a single polypeptide chain.
  • the scFv polypeptide further comprises a polypeptide linker between the V H and V L domains which enables the scFv to form the desired structure for antigen binding.
  • Plückthun in The Pharmacology of Monoclonal Antibodies, vol. 113, Rosenburg and Moore eds., Springer-Verlag, New York, pp. 269-315 (1994) .
  • CDR complementarity determining region
  • CDR complementarity determining region
  • the CDR sequences provided herein are based on IMGT definition.
  • the CDR sequences may be determined by the VBASE2 tool (http: //www. vbase2. org/vbase2. php, see also Retter I, Althaus HH, Münch R, Müller W: VBASE2, an integrative V gene database. Nucleic Acids Res. 2005 Jan 1; 33 (Database issue) : D671-4, which is incorporated herein by reference in its entirety) .
  • osteoporosis refers to premenopausal idiopathic osteoporosis, postmenopausal osteoporosis, menopausal osteoporosis, postoophorectomy osteoporosis, osteoporosis of disuse, drug-induced osteoporosis, osteoporosis due to malabsorption, post-surgical malabsorption osteoporosis and/or senile osteoporosis.
  • osteoopenia refers to premenopausal idiopathic osteopenia, postmenopausal osteopenia, senile osteopenia, drug-induced osteopenia, osteopenia of disuse, neonatal osteopenia and/or spaceflight osteopenia caused by reduced gravity.
  • metabolic bone diseases includes but not limit to renal osteodystrophy, primary and secondary hyperparathyroidism, familial hyperparathyroidism syndromes, parathyroid disorders, osteodystrophy, osteochondrosis, hyperphosphatasia.
  • osteonecrosis refers to avascular necrosis of bone, avascular necrosis secondary to diving, osteonecrosis of jaw.
  • bone loss refers to postmenopausal bone loss, Immobilization-induced bone loss, Weightlessness induced bone loss, Disease associated facial bone loss, Disease associated cranial bone loss, Disease associated bone loss of the jaw, Disease associated bone loss of the skull, bone loss associated with space travel, glucocorticoid-induced bone loss, Drug-induced bone loss, Organ transplant related bone loss, Kidney transplant related bone loss, HIV associated bone loss, bone loss associated with loss of growth hormone, bone loss associated with cystic fibrosis, Chemotherapy associated bone loss, Tumor induced bone loss, Cancer-related bone loss, Hormone ablative bone loss, Oral bone loss, Heparin-induced bone loss, Inflammation-induced bone loss including arthritis-induced bone loss or other disease or condition associated with a) bone loss of either quantity or quality or both and/or b) abnormality of bone structure and quality. bone loss caused by reduced gravity.
  • nonunion or “delay bone healing” as used herein refers to delayed or non-union bone fractures, hip fracture, pseudoarthritis after fusion or arthrodesis, osteolysis, postsurgical osteolysis, nonunion after spinal arthrodesis, enhancement/acceleration of spinal fusion, chronic pain after arthroplasty.
  • osteomalacia refers to Vitamin-D-resistant osteomalacia, calcium deficiency, sarcopenia, cancer sarcopenia, tumor-induced osteomalacia.
  • fracture includes but not limited to compression fracture, fragility fracture, pathologic fracture, stress fracture, hip fracture, fracture of femoral neck, atypical hip fracture, femoral intertrochanter fracture, fracture of bone in neoplastic disease.
  • hypercalcemia includes hypercalcemia of malignancy, myopathy due to hypercalcemia, hypercalcemia in chronic kidney disease.
  • multiple myeloma related bone disorders refers to multiple myeloma bone disease and ore osteoporosis in multiple myelomatosis.
  • primary bone tumor includes osteosarcoma, osteochondroma, osteoblastoma, osteochondromyxoma, osteoclastoma, osteoma, osteoid osteoma, chondrosarcoma, chondroblastoma, chondromyxoid fibroma, myxoid chondrosarcoma, sarcoma, ewing sarcoma, kaposi sarcoma, periosteal sarcoma, glomangiosarcoma, giant cell tumor, giant cell sarcoma, giant cell angiofibroma, haemangioendothelial sarcoma, undifferentiated sarcoma, fibrosarcoma, bone cyst, aneurysmal bone cyst, multiple endocrine neoplasia.
  • malignancies for “bone metastasis of malignancies” includes breast cancer, lung cancer, hepatic cancer, ovarian cancer, pancreatic cancer, colorectal cancer, gastric cancer, prostate cancer, thyroid cancer, thymus cancer.
  • osteomyelitis refers to osteomyelitis, pyogenic osteomyelitis, ankylosing spondylitis.
  • bone marrow or haemotological disordersdiseases refers to leukemia, malignant lymphoma, haematological malignancy, haematologic disease, bone marrow disease.
  • muscle rare disease includes Osteogenesis imperfecta, Albers-Schonberg disease, congenital pseudarthrosis of the tibia, enchondromatosis, fibrous dysplasia, Gaucher's Disease, Marfan's syndrome, multiple hereditary exotoses, neurofibromatosis, osteogenesis imperfecta, osteopetrosis, osteopoikilosis, sclerotic lesions, pseudoarthrosis, , melorheostosis, Juvenile arthritides, thalassemia, mucopolysaccharidoses, turner syndrome, Pown Syndrome, Klinefelter Syndrome, leprosy, Perthes' Disease, adolescent idiopathic scoliosis, Winchester Syndrome, Menkes Disease, ischemic bone disease (such as Legg-Calve-Perthes disease, regional migratory osteoporosis) , Idiopathic infantile hypercalcemia, Acromegaly,
  • carrier-related disorder includes but not limited to Chondromatosis, Chondrodysplasia, Chondrodystrophic myotonia, Juxtacortical chondroma, Tear of cartilage of knee, Osteoarthritis, Osteochondrodystrophy.
  • cancer-related disorder includes sarcopenia and cancer sarcopenia.
  • kits as used in “facilitation of heal after bone or joint surgeries” refers to orthopedic procedures, dental procedures, implant surgery, joint replacement, joint-preserving surgery, distraction osteogenesis, bone lengthening, bone grafting, bone cosmetic surgery and bone repair such as fracture healing, nonunion healing, delayed union healing and facial reconstruction.
  • variable-domain residue-numbering as in Kabat or “amino-acid-position numbering as in Kabat, ” and variations thereof, refers to the numbering system used for heavy-chain variable domains or light-chain variable domains of the compilation of antibodies in Kabat et al., supra. Using this numbering system, the actual linear amino acid sequence may contain fewer or additional amino acids corresponding to a shortening of, or insertion into, a FR or hypervariable region (HVR) of the variable domain.
  • a heavy-chain variable domain may include a single amino acid insert (residue 52a according to Kabat) after residue 52 of H2 and inserted residues (e.g.
  • residues 82a, 82b, and 82c, etc. according to Kabat after heavy-chain FR residue 82.
  • the Kabat numbering of residues may be determined for a given antibody by alignment at regions of homology of the sequence of the antibody with a “standard” Kabat numbered sequence.
  • the numbering of the residues in an immunoglobulin heavy chain is that of the EU index as in Kabat et al., supra.
  • the “EU index as in Kabat” refers to the residue numbering of the human IgG1 EU antibody.
  • Framework or “FR” residues are those variable-domain residues other than the CDR residues as herein defined.
  • “Humanized” forms of non-human (e.g., rodent) antibodies are chimeric antibodies that contain minimal sequence derived from the non-human antibody.
  • humanized antibodies are human immunoglobulins (recipient antibody) in which residues from a hypervariable region (HVR) of the recipient are replaced by residues from a hypervariable region of a non-human species (donor antibody) such as mouse, rat, rabbit or non-human primate having the desired antibody specificity, affinity, and capability.
  • donor antibody such as mouse, rat, rabbit or non-human primate having the desired antibody specificity, affinity, and capability.
  • framework region (FR) residues of the human immunoglobulin are replaced by corresponding non-human residues.
  • humanized antibodies can comprise residues that are not found in the recipient antibody or in the donor antibody. These modifications are made to further refine antibody performance.
  • the humanized antibody will comprise substantially all of at least one, and typically two, variable domains, in which all or substantially all of the hypervariable loops correspond to those of a non-human immunoglobulin and all or substantially all of the FRs are those of a human immunoglobulin sequence.
  • the humanized antibody optionally also will comprise at least a portion of an immunoglobulin constant region (Fc) , typically that of a human immunoglobulin.
  • Fc immunoglobulin constant region
  • a “human antibody” is an antibody that possesses an amino-acid sequence corresponding to that of an antibody produced by a human and/or has been made using any of the techniques for making human antibodies as disclosed herein. This definition of a human antibody specifically excludes a humanized antibody comprising non-human antigen-binding residues.
  • Human antibodies can be produced using various techniques known in the art, including phage-display libraries. Hoogenboom and Winter, J. Mol. Biol., 227: 381 (1991) ; Marks et al., J. Mol. Biol., 222: 581 (1991) . Also available for the preparation of human monoclonal antibodies are methods described in Cole et al., Monoclonal Antibodies and Cancer Therapy, Alan R.
  • Human antibodies can be prepared by administering the antigen to a transgenic animal that has been modified to produce such antibodies in response to antigenic challenge, but whose endogenous loci have been disabled, e.g., immunized xenomice (see, e.g., U.S. Pat. Nos. 6,075,181 and 6,150,584 regarding XENOMOUSE TM technology) . See also, for example, Li et al., Proc. Natl. Acad. Sci. USA, 103: 3557-3562 (2006) regarding human antibodies generated via a human B-cell hybridoma technology.
  • Percent (%) amino acid sequence identity or “homology” with respect to the polypeptide and antibody sequences identified herein is defined as the percentage of amino acid residues in a candidate sequence that are identical with the amino acid residues in the polypeptide being compared, after aligning the sequences considering any conservative substitutions as part of the sequence identity. Alignment for purposes of determining percent amino acid sequence identity can be achieved in various ways that are within the skill in the art, for instance, using publicly available computer software such as BLAST, BLAST-2, ALIGN, Megalign (DNASTAR) , or MUSCLE software. Those skilled in the art can determine appropriate parameters for measuring alignment, including any algorithms needed to achieve maximal alignment over the full-length of the sequences being compared.
  • %amino acid sequence identity values are generated using the sequence comparison computer program MUSCLE (Edgar, R.C., Nucleic Acids Research 32 (5) : 1792-1797, 2004; Edgar, R.C., BMC Bioinformatics 5 (1) : 113, 2004) .
  • “Homologous” refers to the sequence similarity or sequence identity between two polypeptides or between two nucleic acid molecules. When a position in both of the two compared sequences is occupied by the same base or amino acid monomer subunit, e.g., if a position in each of two DNA molecules is occupied by adenine, then the molecules are homologous at that position.
  • the percent of homology between two sequences is a function of the number of matching or homologous positions shared by the two sequences divided by the number of positions compared times 100. For example, if 6 of 10 of the positions in two sequences are matched or homologous then the two sequences are 60%homologous.
  • the DNA sequences ATTGCC and TATGGC share 50%homology. Generally, a comparison is made when two sequences are aligned to give maximum homology.
  • constant domain refers to the portion of an immunoglobulin molecule having a more conserved amino acid sequence relative to the other portion of the immunoglobulin, the variable domain, which contains the antigen-binding site.
  • the constant domain contains the C H 1, C H 2 and C H 3 domains (collectively, C H ) of the heavy chain and the CHL (or C L ) domain of the light chain.
  • the “light chains” of antibodies (immunoglobulins) from any mammalian species can be assigned to one of two clearly distinct types, called kappa ( “ ⁇ ” ) and lambda ( “ ⁇ ” ) , based on the amino acid sequences of their constant domains.
  • C H 1 domain (also referred to as “C1” of “H1” domain) usually extends from about amino acid 118 to about amino acid 215 (EU numbering system) .
  • Hinge region is generally defined as a region in IgG corresponding to Glu216 to Pro230 of human IgG1 (Burton, Molec. Immunol. 22: 161-206 (1985) ) . Hinge regions of other IgG isotypes may be aligned with the IgG1 sequence by placing the first and last cysteine residues forming inter-heavy chain S-Sbonds in the same positions.
  • C H 2 domain of a human IgG Fc region usually extends from about amino acid 231 to about amino acid 340.
  • the C H 2 domain is unique in that it is not closely paired with another domain. Rather, two N-linked branched carbohydrate chains are interposed between the two C H 2 domains of an intact native IgG molecule. It has been speculated that the carbohydrate may provide a substitute for the domain-domain pairing and help stabilize the CH2 domain.
  • C H 3 domain (also referred to as “C3” domain) comprises the stretch of residues C-terminal to a C H 2 domain in an Fc region (i.e. from about amino acid residue 341 to the C-terminal end of an antibody sequence, typically at amino acid residue 446 or 447 of an IgG) .
  • Fc region or “fragment crystallizable region” herein is used to define a C-terminal region of an immunoglobulin heavy chain, including native-sequence Fc regions and variant Fc regions.
  • the boundaries of the Fc region of an immunoglobulin heavy chain might vary, the human IgG heavy-chain Fc region is usually defined to stretch from an amino acid residue at position Cys226, or from Pro230, to the carboxyl-terminus thereof.
  • the C-terminal lysine (residue 447 according to the EU numbering system) of the Fc region may be removed, for example, during production or purification of the antibody, or by recombinantly engineering the nucleic acid encoding a heavy chain of the antibody.
  • composition of intact antibodies may comprise antibody populations with all K447 residues removed, antibody populations with no K447 residues removed, and antibody populations having a mixture of antibodies with and without the K447 residue.
  • Suitable native-sequence Fc regions for use in the antibodies described herein include human IgG1, IgG2 (IgG2A, IgG2B) , IgG3 and IgG4.
  • Fc receptor or “FcR” describes a receptor that binds the Fc region of an antibody.
  • the preferred FcR is a native sequence human FcR.
  • a preferred FcR is one which binds an IgG antibody (agamma receptor) and includes receptors of the Fc ⁇ RI, Fc ⁇ RII, and Fc ⁇ RIII subclasses, including allelic variants and alternatively spliced forms of these receptors
  • Fc ⁇ RII receptors include Fc ⁇ RIIA (an “activating receptor” ) and Fc ⁇ RIIB (an “inhibiting receptor” ) , which have similar amino acid sequences that differ primarily in the cytoplasmic domains thereof.
  • Activating receptor Fc ⁇ RIIA contains an immunoreceptor tyrosine-based activation motif (ITAM) in its cytoplasmic domain.
  • Inhibiting receptor Fc ⁇ RIIB contains an immunoreceptor tyrosine-based inhibition motif (ITIM) in its cytoplasmic domain.
  • ITAM immunoreceptor tyrosine-based activation motif
  • ITIM immunoreceptor tyrosine-based inhibition motif
  • epitope refers to the specific group of atoms or amino acids on an antigen to which an antibody or antibody moiety binds. Two antibodies or antibody moieties may bind the same epitope within an antigen if they exhibit competitive binding for the antigen.
  • a first antibody or fragment thereof “competes” for binding to a target antigen with a second antibody or fragment thereof when the first antibody or fragment thereof inhibits the target antigen binding of the second antibody of fragment thereof by at least about 50% (such as at least about any one of 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, 98%or 99%) in the presence of an equimolar concentration of the first antibody or fragment thereof, or vice versa.
  • a high throughput process for “binning” antibodies based upon their cross-competition is described in PCT Publication No. WO 03/48731.
  • the terms “specifically binds, ” “specifically recognizing, ” and “is specific for” refer to measurable and reproducible interactions, such as binding between a target and an antibody or antibody moiety, which is determinative of the presence of the target in the presence of a heterogeneous population of molecules, including biological molecules.
  • an antibody or antibody moiety that specifically recognizes a target is an antibody or antibody moiety that binds this target with greater affinity, avidity, more readily, and/or with greater duration than its bindings to other targets.
  • the extent of binding of an antibody to an unrelated target is less than about 10%of the binding of the antibody to the target as measured, e.g., by a radioimmunoassay (RIA) .
  • an antibody that specifically binds a target has a dissociation constant (K D ) of ⁇ 10 -5 M, ⁇ 10 -6 M, ⁇ 10 -7 M, ⁇ 10 -8 M, ⁇ 10 -9 M, ⁇ 10 -10 M, ⁇ 10 -11 M, or ⁇ 10 -12 M.
  • K D dissociation constant
  • an antibody specifically binds an epitope on a protein that is conserved among the protein from different species.
  • specific binding can include, but does not require exclusive binding.
  • Binding specificity of the antibody or antigen-binding domain can be determined experimentally by methods known in the art. Such methods comprise, but are not limited to Western blots, ELISA-, RIA-, ECL-, IRMA-, EIA-, BLI-, BIACORE TM -tests and peptide scans.
  • an “isolated” antibody is one that has been identified, separated and/or recovered from a component of its production environment (e.g., natural or recombinant) .
  • the isolated polypeptide is free of association with all other components from its production environment.
  • an “isolated” nucleic acid molecule encoding a construct, antibody, or antigen-binding fragment thereof described herein is a nucleic acid molecule that is identified and separated from at least one contaminant nucleic acid molecule with which it is ordinarily associated in the environment in which it was produced. Preferably, the isolated nucleic acid is free of association with all components associated with the production environment.
  • the isolated nucleic acid molecules encoding the polypeptides and antibodies described herein is in a form other than in the form or setting in which it is found in nature. Isolated nucleic acid molecules therefore are distinguished from nucleic acid encoding the polypeptides and antibodies described herein existing naturally in cells.
  • An isolated nucleic acid includes a nucleic acid molecule contained in cells that ordinarily contain the nucleic acid molecule, but the nucleic acid molecule is present extrachromosomally or at a chromosomal location that is different from its natural chromosomal location.
  • Nucleic acid is “operably linked” when it is placed into a functional relationship with another nucleic acid sequence.
  • DNA for a presequence or secretory leader is operably linked to DNA for a polypeptide if it is expressed as a preprotein that participates in the secretion of the polypeptide;
  • a promoter or enhancer is operably linked to a coding sequence if it affects the transcription of the sequence; or
  • a ribosome binding site is operably linked to a coding sequence if it is positioned so as to facilitate translation.
  • “operably linked” means that the DNA sequences being linked are contiguous, and, in the case of a secretory leader, contiguous and in reading frame. However, enhancers do not have to be contiguous. Linking is accomplished by ligation at convenient restriction sites. If such sites do not exist, the synthetic oligonucleotide adaptors or linkers are used in accordance with conventional practice.
  • vector refers to a nucleic acid molecule capable of propagating another nucleic acid to which it is linked.
  • the term includes the vector as a self-replicating nucleic acid structure as well as the vector incorporated into the genome of a host cell into which it has been introduced.
  • Certain vectors are capable of directing the expression of nucleic acids to which they are operatively linked. Such vectors are referred to herein as “expression vectors. ”
  • transfected or “transformed” or “transduced” as used herein refers to a process by which exogenous nucleic acid is transferred or introduced into the host cell.
  • a “transfected” or “transformed” or “transduced” cell is one which has been transfected, transformed or transduced with exogenous nucleic acid.
  • the cell includes the primary subject cell and its progeny.
  • host cell refers to cells into which exogenous nucleic acid has been introduced, including the progeny of such cells.
  • Host cells include “transformants” and “transformed cells, ” which include the primary transformed cell and progeny derived therefrom without regard to the number of passages. Progeny may not be completely identical in nucleic acid content to a parent cell, and may contain mutations. Mutant progeny that has the same function or biological activity as screened or selected for in the originally transformed cell are included herein.
  • treatment is an approach for obtaining beneficial or desired results, including clinical results.
  • beneficial or desired clinical results include, but are not limited to, one or more of the following: alleviating one or more symptoms resulting from the disease, diminishing the extent of the disease, stabilizing the disease, preventing or delaying the spread of the disease, preventing or delaying the recurrence of the disease, delaying or slowing the progression of the disease, ameliorating the disease state, providing a remission (partial or total) of the disease, decreasing the dose of one or more other medications required to treat the disease, delaying the progression of the disease, increasing or improving the quality of life, increasing weight gain, and/or prolonging survival.
  • the methods of the application contemplate any one or more of these aspects of treatment.
  • inhibitors refer to a decrease or cessation of any phenotypic characteristic or to the decrease or cessation in the incidence, degree, or likelihood of that characteristic.
  • To “reduce” or “inhibit” is to decrease, reduce or arrest an activity, function, and/or amount as compared to that of a reference.
  • by “reduce” or “inhibit” is meant the ability to cause an overall decrease of 20%or greater.
  • by “reduce” or “inhibit” is meant the ability to cause an overall decrease of 50%or greater.
  • by “reduce” or “inhibit” is meant the ability to cause an overall decrease of 75%, 85%, 90%, 95%, or greater.
  • a “reference” as used herein, refers to any sample, standard, or level that is used for comparison purposes.
  • a reference may be obtained from a healthy and/or non-diseased sample.
  • a reference may be obtained from an untreated sample.
  • a reference is obtained from a non-diseased or non-treated sample of an individual.
  • a reference is obtained from one or more healthy individuals who are not the individual or patient.
  • delay development of a disease means to defer, hinder, slow, retard, stabilize, suppress and/or postpone development of the disease. This delay can be of varying lengths of time, depending on the history of the disease and/or individual being treated. As is evident to one skilled in the art, a sufficient or significant delay can, in effect, encompass prevention, in that the individual does not develop the disease.
  • Preventing includes providing prophylaxis with respect to the occurrence or recurrence of a disease in an individual that may be predisposed to the disease but has not yet been diagnosed with the disease.
  • to “suppress” a function or activity is to reduce the function or activity when compared to otherwise same conditions except for a condition or parameter of interest, or alternatively, as compared to another condition.
  • an antibody which suppresses tumor growth reduces the rate of growth of the tumor compared to the rate of growth of the tumor in the absence of the antibody.
  • subject “individual, ” and “patient” are used interchangeably herein to refer to a mammal, including, but not limited to, human, bovine, horse, feline, canine, rodent, or primate. In some embodiments, the individual is a human.
  • an “effective amount” of an agent refers to an amount effective, at dosages and for periods of time necessary, to achieve the desired therapeutic or prophylactic result.
  • the specific dose may vary depending on one or more of: the particular agent chosen, the dosing regimen to be followed, whether it is administered in combination with other compounds, timing of administration, the tissue to be imaged, and the physical delivery system in which it is carried.
  • pharmaceutical formulation and “pharmaceutical composition” refer to a preparation which is in such form as to permit the biological activity of the active ingredient (s) to be effective, and which contains no additional components which are unacceptably toxic to an individual to which the formulation would be administered. Such formulations may be sterile.
  • a “pharmaceutically acceptable carrier” refers to a non-toxic solid, semisolid, or liquid filler, diluent, encapsulating material, formulation auxiliary, or carrier conventional in the art for use with a therapeutic agent that together comprise a “pharmaceutical composition” for administration to an individual.
  • a pharmaceutically acceptable carrier is non-toxic to recipients at the dosages and concentrations employed and is compatible with other ingredients of the formulation.
  • the pharmaceutically acceptable carrier is appropriate for the formulation employed.
  • Pharmaceutically acceptable carriers or excipients have preferably met the required standards of toxicological and manufacturing testing and/or are included on the Inactive Ingredient Guide prepared by the U.S. Food and Drug administration.
  • a “sterile” formulation is aseptic or essentially free from living microorganisms and their spores.
  • Administration “in combination with” one or more further therapeutic agents includes simultaneous (concurrent) and consecutive or sequential administration in any order.
  • the term “concurrently” is used herein to refer to administration of two or more therapeutic agents, where at least part of the administration overlaps in time or where the administration of one therapeutic agent falls within a short period of time relative to administration of the other therapeutic agent.
  • the two or more therapeutic agents are administered with a time separation of no more than about 60 minutes, such as no more than about any of 30, 15, 10, 5, or 1 minutes.
  • administration of two or more therapeutic agents where the administration of one or more agent (s) continues after discontinuing the administration of one or more other agent (s) .
  • administration of the two or more therapeutic agents are administered with a time separation of more than about 15 minutes, such as about any of 20, 30, 40, 50, or 60 minutes, 1 day, 2 days, 3 days, 1 week, 2 weeks, or 1 month, or longer.
  • conjunction with refers to administration of one treatment modality in addition to another treatment modality.
  • in conjunction with refers to administration of one treatment modality before, during or after administration of the other treatment modality to the individual.
  • package insert is used to refer to instructions customarily included in commercial packages of therapeutic products, that contain information about the indications, usage, dosage, administration, combination therapy, contraindications and/or warnings concerning the use of such therapeutic products.
  • An “article of manufacture” is any manufacture (e.g., a package or container) or kit comprising at least one reagent, e.g., a medicament for treatment of a disease or disorder, or a probe for specifically detecting a biomarker described herein.
  • the manufacture or kit is promoted, distributed, or sold as a unit for performing the methods described herein.
  • references to “about” a value or parameter herein includes (and describes) variations that are directed to that value or parameter per se. For example, description referring to “about X” includes description of “X” .
  • the present application provides anti-Sclerostin constructs comprising an anti-Sclerostin antibody moiety that specifically binds to Sclerostin (product of SOST) as described herein.
  • Sclerostin is a secreted glycoprotein with a C-terminal cysteine knot-like (CTCK) domain and sequence similarity to the DAN (differential screening-selected gene aberrative in neuroblastoma) family of bone morphogenetic protein (BMP) antagonists.
  • CCK C-terminal cysteine knot-like
  • BMP bone morphogenetic protein
  • an anti-Sclerostin construct comprising an antibody moiety that specifically recognizes Sclerostin, wherein the antibody moiety binds to an epitope on Sclerostin, wherein the epitope comprises the amino acid sequence set forth in SEQ ID NO: 186.
  • the anti-Sclerostin construct comprises an antibody moiety comprising a heavy chain variable region (V H ) and a light chain variable region (V L ) , wherein the antibody moiety competes for a binding epitope of Sclerostin with an antibody or antibody fragment comprising a second heavy variable region (V H-2 ) and a second light chain variable region (V L-2 ) , wherein the V H-2 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 1, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 5, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 9, and the V L-2 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 15, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 20.
  • V H-2 comprises the HC-CDR1 comprising the amino acid sequence of S
  • the anti-Sclerostin construct comprises an antibody moiety comprising a heavy chain variable region (V H ) and a light chain variable region (V L ) , wherein the antibody moiety competes for a binding epitope of Sclerostin with an antibody or antibody fragment comprising a second heavy variable region (V H-2 ) and a second light chain variable region (V L-2 )
  • the V H-2 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 1, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 6, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 10
  • the V L-2 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 15, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 20.
  • the anti-Sclerostin construct comprises an antibody moiety comprising a heavy chain variable region (V H ) and a light chain variable region (V L ) , wherein the antibody moiety competes for a binding epitope of Sclerostin with an antibody or antibody fragment comprising a second heavy variable region (V H-2 ) and a second light chain variable region (V L-2 )
  • the V H-2 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 2
  • the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 7, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 10
  • the V L-2 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 15, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 20.
  • the anti-Sclerostin construct comprises an antibody moiety comprising a heavy chain variable region (V H ) and a light chain variable region (V L ) , wherein the antibody moiety competes for a binding epitope of Sclerostin with an antibody or antibody fragment comprising a second heavy variable region (V H-2 ) and a second light chain variable region (V L-2 )
  • the V H-2 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 2
  • the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 6, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 10
  • the V L-2 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 15, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 20.
  • the anti-Sclerostin construct comprises an antibody moiety comprising a heavy chain variable region (V H ) and a light chain variable region (V L ) , wherein the antibody moiety competes for a binding epitope of Sclerostin with an antibody or antibody fragment comprising a second heavy variable region (V H-2 ) and a second light chain variable region (V L-2 ) , wherein the V H-2 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 1, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 5, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 10, and the V L-2 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 16, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 20.
  • V H-2 comprises the HC-CDR1 comprising the amino acid sequence of S
  • the anti-Sclerostin construct comprises an antibody moiety comprising a heavy chain variable region (V H ) and a light chain variable region (V L ) , wherein the antibody moiety competes for a binding epitope of Sclerostin with an antibody or antibody fragment comprising a second heavy variable region (V H-2 ) and a second light chain variable region (V L-2 )
  • the V H-2 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 3, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 7, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 10
  • the V L-2 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 15, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 20.
  • the anti-Sclerostin construct comprises an antibody moiety comprising a heavy chain variable region (V H ) and a light chain variable region (V L ) , wherein the antibody moiety competes for a binding epitope of Sclerostin with an antibody or antibody fragment comprising a second heavy variable region (V H-2 ) and a second light chain variable region (V L-2 ) , wherein the V H-2 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 1, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 5, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 10, and the V L-2 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 16, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 20.
  • V H-2 comprises the HC-CDR1 comprising the amino acid sequence of S
  • the anti-Sclerostin construct comprises an antibody moiety comprising a heavy chain variable region (V H ) and a light chain variable region (V L ) , wherein the antibody moiety competes for a binding epitope of Sclerostin with an antibody or antibody fragment comprising a second heavy variable region (V H-2 ) and a second light chain variable region (V L-2 )
  • the V H-2 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 4, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 8, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 11
  • the V L-2 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 17, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 19, and the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 21.
  • the anti-Sclerostin construct comprises an antibody moiety comprising a heavy chain variable region (V H ) and a light chain variable region (V L ) , wherein the antibody moiety competes for a binding epitope of Sclerostin with an antibody or antibody fragment comprising a second heavy variable region (V H-2 ) and a second light chain variable region (V L-2 )
  • the V H-2 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 2
  • the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 6, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 10
  • the V L-2 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 15, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 20.
  • the anti-Sclerostin construct comprises an antibody moiety comprising a heavy chain variable region (V H ) and a light chain variable region (V L ) , wherein the antibody moiety competes for a binding epitope of Sclerostin with an antibody or antibody fragment comprising a second heavy variable region (V H-2 ) and a second light chain variable region (V L-2 ) , wherein the V H-2 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 1, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 5, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 9, and the V L-2 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 85, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 20.
  • V H-2 comprises the HC-CDR1 comprising the amino acid sequence of
  • the anti-Sclerostin construct comprises an antibody moiety comprising a heavy chain variable region (V H ) and a light chain variable region (V L ) , wherein the antibody moiety competes for a binding epitope of Sclerostin with an antibody or antibody fragment comprising a second heavy variable region (V H-2 ) and a second light chain variable region (V L-2 ) , wherein the V H-2 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 1, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 5, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 9, and the V L-2 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 86, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 20.
  • V H-2 comprises the HC-CDR1 comprising the amino acid sequence
  • the V H comprises i) the HC-CDR1 comprising the amino acid sequence of any one of SEQ ID NOs: 1-4 and 12, ii) the HC-CDR2 comprising the amino acid sequence of any one of SEQ ID NOs: 5-8 and 13, and iii) the HC-CDR3 comprising the amino acid sequence any one of SEQ ID NOs: 9-11 and 14, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the HC-CDRs, and the V L comprises i) the LC-CDR1 comprising the amino acid sequence of any one of SEQ ID NOs: 15-17, ii) the LC-CDR2 comprising the amino acid sequence of any one of SEQ ID NOs: 18 and 19, and iii) the LC- CDR3 comprising the amino acid sequence of any one of SEQ ID NOs: 20 and 21, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the LC-CDRs.
  • the anti-Sclerostin construct comprises an antibody moiety comprising a heavy chain variable region (V H ) and a light chain variable region (V L ) , wherein the V H comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 12, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 13, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 14; and the V L comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 15 or 16, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and the LC-CDR3 comprising the amino acid sequence of any one of SEQ ID NOs: 20.
  • V H comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 12
  • the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 13
  • the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 14
  • the anti-Sclerostin construct comprises an antibody moiety comprising a heavy chain variable region (V H ) and a light chain variable region (V L )
  • V H comprises i) the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 1, ii) the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 5, and iii) the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 9, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the HC-CDRs
  • the V L comprises i) the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 15, ii) the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and iii) the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 20, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the LC-
  • the amino acid substitutions described above are limited to “exemplary substitutions” shown in Table 2 of this application. In some embodiments, the amino acid substitutions are limited to “preferred substitutions” shown in Table 2 of this application.
  • the V H comprises i) the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 1, ii) the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 5, and iii) the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 9, and the V L comprises i) the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 15, ii) the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and iii) the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 20.
  • the V H comprises an amino acid sequence of SEQ ID NO: 87, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity; and the V L comprises an amino acid sequence of SEQ ID NO: 88, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity.
  • the V H comprises an amino acid sequence of SEQ ID NO: 22, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity; and the V L comprises an amino acid sequence of SEQ ID NO: 23, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity.
  • the V H comprises an amino acid sequence of SEQ ID NO: 26, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity; and the V L comprises an amino acid sequence of SEQ ID NO: 27, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity.
  • the anti-Sclerostin construct comprises an antibody moiety comprising a heavy chain variable region (V H ) and a light chain variable region (V L )
  • V H comprises i) the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 1, ii) the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 6, and iii) the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 10, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the HC-CDRs
  • the V L comprises i) the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 15, ii) the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and iii) the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 20, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the LC-
  • the amino acid substitutions described above are limited to “exemplary substitutions” shown in Table 2 of this application. In some embodiments, the amino acid substitutions are limited to “preferred substitutions” shown in Table 2 of this application.
  • the V H comprises an amino acid sequence of SEQ ID NO: 24, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity; and the V L comprises an amino acid sequence of SEQ ID NO: 25, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity.
  • the V H comprises an amino acid sequence of SEQ ID NO: 36, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity; and the V L comprises an amino acid sequence of SEQ ID NO: 37, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity.
  • the anti-Sclerostin construct comprises an antibody moiety comprising a heavy chain variable region (V H ) and a light chain variable region (V L )
  • V H comprises i) the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 2, ii) the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 7, and iii) the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 10, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the HC-CDRs
  • the V L comprises i) the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 15, ii) the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and iii) the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 20, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the LC-
  • the amino acid substitutions described above are limited to “exemplary substitutions” shown in Table 2 of this application. In some embodiments, the amino acid substitutions are limited to “preferred substitutions” shown in Table 2 of this application.
  • the V H comprises an amino acid sequence of SEQ ID NO: 28, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity; and the V L comprises an amino acid sequence of SEQ ID NO: 29, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity.
  • the anti-Sclerostin construct comprises an antibody moiety comprising a heavy chain variable region (V H ) and a light chain variable region (V L )
  • V H comprises i) the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 2, ii) the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 6, and iii) the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 10, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the HC-CDRs
  • the V L comprises i) the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 15, ii) the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and iii) the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 20, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the LC-
  • the amino acid substitutions described above are limited to “exemplary substitutions” shown in Table 2 of this application. In some embodiments, the amino acid substitutions are limited to “preferred substitutions” shown in Table 2 of this application.
  • the V H comprises an amino acid sequence of SEQ ID NO: 30, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity; and the V L comprises an amino acid sequence of SEQ ID NO: 31, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity.
  • the anti-Sclerostin construct comprises an antibody moiety comprising a heavy chain variable region (V H ) and a light chain variable region (V L )
  • V H comprises i) the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 1, ii) the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 5, and iii) the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 10, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the HC-CDRs
  • the V L comprises i) the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 16, ii) the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and iii) the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 20, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the LC-
  • the amino acid substitutions described above are limited to “exemplary substitutions” shown in Table 2 of this application. In some embodiments, the amino acid substitutions are limited to “preferred substitutions” shown in Table 2 of this application.
  • the V H comprises an amino acid sequence of SEQ ID NO: 32, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity; and the V L comprises an amino acid sequence of SEQ ID NO: 33, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity.
  • the anti-Sclerostin construct comprises an antibody moiety comprising a heavy chain variable region (V H ) and a light chain variable region (V L )
  • V H comprises i) the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 3, ii) the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 7, and iii) the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 10, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the HC-CDRs
  • the V L comprises i) the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 15, ii) the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and iii) the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 20, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the LC-
  • the amino acid substitutions described above are limited to “exemplary substitutions” shown in Table 2 of this application. In some embodiments, the amino acid substitutions are limited to “preferred substitutions” shown in Table 2 of this application.
  • the V H comprises an amino acid sequence of SEQ ID NO: 34, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity; and the V L comprises an amino acid sequence of SEQ ID NO: 35, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity.
  • the anti-Sclerostin construct comprises an antibody moiety comprising a heavy chain variable region (V H ) and a light chain variable region (V L )
  • V H comprises i) the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 1, ii) the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 5, and iii) the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 10, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the HC-CDRs
  • the V L comprises i) the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 16, ii) the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and iii) the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 20, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the LC-
  • the amino acid substitutions described above are limited to “exemplary substitutions” shown in Table 2 of this application. In some embodiments, the amino acid substitutions are limited to “preferred substitutions” shown in Table 2 of this application.
  • the V H comprises an amino acid sequence of SEQ ID NO: 38, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity; and the V L comprises an amino acid sequence of SEQ ID NO: 39, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity.
  • the anti-Sclerostin construct comprises an antibody moiety comprising a heavy chain variable region (V H ) and a light chain variable region (V L )
  • V H comprises i) the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 4, ii) the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 8, and iii) the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 11, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the HC-CDRs
  • the V L comprises i) the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 17, ii) the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 19, and iii) the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 21, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the LC-
  • the amino acid substitutions described above are limited to “exemplary substitutions” shown in Table 2 of this application. In some embodiments, the amino acid substitutions are limited to “preferred substitutions” shown in Table 2 of this application.
  • the V H comprises an amino acid sequence of SEQ ID NO: 40, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity; and the V L comprises an amino acid sequence of SEQ ID NO: 41, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity.
  • the anti-Sclerostin construct comprises an antibody moiety comprising a heavy chain variable region (V H ) and a light chain variable region (V L )
  • V H comprises i) the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 1, ii) the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 5, and iii) the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 9, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the HC-CDRs
  • the V L comprises i) the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 85, ii) the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and iii) the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 20, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the LC
  • the amino acid substitutions described above are limited to “exemplary substitutions” shown in Table 2 of this application. In some embodiments, the amino acid substitutions are limited to “preferred substitutions” shown in Table 2 of this application.
  • the V H comprises i) the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 1, ii) the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 5, and iii) the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 9, and the V L comprises i) the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 85, ii) the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and iii) the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 20.
  • the V H comprises an amino acid sequence of SEQ ID NO: 87, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity; and the V L comprises an amino acid sequence of SEQ ID NO: 89, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity.
  • the anti-Sclerostin construct comprises an antibody moiety comprising a heavy chain variable region (V H ) and a light chain variable region (V L )
  • V H comprises i) the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 1, ii) the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 5, and iii) the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 9, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the HC-CDRs
  • the V L comprises i) the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 86, ii) the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and iii) the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 20, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the
  • the amino acid substitutions described above are limited to “exemplary substitutions” shown in Table 2 of this application. In some embodiments, the amino acid substitutions are limited to “preferred substitutions” shown in Table 2 of this application.
  • the V H comprises i) the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 1, ii) the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 5, and iii) the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 9, and the V L comprises i) the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 86, ii) the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and iii) the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 20.
  • the V H comprises an amino acid sequence of SEQ ID NO: 87, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity; and the V L comprises an amino acid sequence of SEQ ID NO: 90, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity.
  • an anti-Sclerostin construct comprising an antibody moiety that specifically recognizes Sclerostin, wherein the antibody moiety comprises a heavy chain variable region (V H ) and a light chain variable region (V L ) , wherein:
  • the construct comprises or is an antibody or antigen-binding fragment thereof selected from the group consisting of a full-length antibody, a bispecific antibody, a single-chain Fv (scFv) fragment, a Fab fragment, a Fab’ fragment, a F (ab’) 2, an Fv fragment, a disulfide stabilized Fv fragment (dsFv) , a dsscFv, a (dsFv) 2 , a V H H, a Fv-Fc fusion, a scFv-Fc fusion, a scFv-Fv fusion, a diabody, a tribody, and a tetrabody.
  • the anti-Sclerostin antibody moiety is a full-length antibody.
  • the anti-Sclerostin antibody moiety is a scFv or dsscFv.
  • the anti-Sclerostin antibody moiety described above comprises an Fc fragment of an immunoglobulin selected from the group consisting of IgG, IgA, IgD, IgE, IgM, and combinations and hybrids thereof.
  • the anti-Sclerostin antibody moiety or the full-length antibody described above comprises an Fc fragment of an immunoglobulin selected from the group consisting of IgG1, IgG2, IgG3, IgG4, and combinations and hybrids thereof.
  • the Fc fragment has a reduced effector function as compared to the corresponding wildtype Fc fragment.
  • the Fc fragment has an enhanced effector function as compared to the corresponding wildtype Fc fragment.
  • the antibody moiety comprises a humanized antibody of any of the antibody moiety described herein.
  • the anti-Sclerostin construct comprises or is an anti-Sclerostin fusion protein.
  • the anti-Sclerostin construct comprises or is a multispecific anti-Sclerostin construct (such as a bispecific antibody) .
  • the Sclerostin is a human Sclerostin.
  • Binding specificity of the antibody moieties can be determined experimentally by methods known in the art. Such methods comprise, but are not limited to Western blots, ELISA-, RIA-, ECL-, IRMA-, EIA-, BLI-, BIACORE TM -tests and peptide scans.
  • the K D of the binding between the antibody moiety and Sclerostin is about 10 -7 M to about 10 -12 M, about 10 -7 M to about 10 -8 M, about 10 -8 M to about 10 -9 M, about 10 -9 M to about 10 -10 M, about 10 -10 M to about 10 -11 M, about 10 -11 M to about 10 - 12 M, about 10 -7 M to about 10 -12 M, about 10 -8 M to about 10 -12 M, about 10 -9 M to about 10 -12 M, about 10 -10 M to about 10 -12 M, about 10 -7 M to about 10 -11 M, about 10 -8 M to about 10 -11 M, about 10 -9 M to about 10 -11 M, about 10 -7 M to about 10 -10 M, about 10 -8 M to about 10 -10 M, or about 10 -7 M to about 10 -9 M.
  • the K D of the binding between the antibody moiety and Sclerostin is stronger than about any one of 10 -7 M, 10 -8 M, 10 -9 M, 10 -10 M, 10 -11 M, or 10 -12 M.
  • the Sclerostin is a human Sclerostin. In some embodiments, Sclerostin is cynomolgus Sclerostin.
  • the K on of the binding between the antibody moiety and Sclerostin is about 10 3 M -1 s -1 to about 10 8 M -1 s -1 , about 10 3 M -1 s -1 to about 10 4 M -1 s -1 , about 10 4 M -1 s -1 to about 10 5 M -1 s -1 , about 10 5 M -1 s -1 to about 10 6 M -1 s -1 , about 10 6 M -1 s -1 to about 10 7 M - 1 s -1 , or about 10 7 M -1 s -1 to about 10 8 M -1 s -1 .
  • the K on of the binding between the antibody moiety and Sclerostin is about 10 3 M -1 s -1 to about 10 5 M -1 s -1 , about 10 4 M - 1 s -1 to about 10 6 M -1 s -1 , about 10 5 M -1 s -1 to about 10 7 M -1 s -1 , about 10 6 M -1 s -1 to about 10 8 M -1 s -1 , about 10 4 M -1 s -1 to about 10 7 M -1 s -1 , or about 10 5 M -1 s -1 to about 10 8 M -1 s -1 .
  • the K on of the binding between the antibody moiety and Sclerostin is no more than about any one of 10 3 M -1 s -1 , 10 4 M -1 s -1 , 10 5 M -1 s -1 , 10 6 M -1 s -1 , 10 7 M -1 s -1 or 10 8 M -1 s -1 .
  • Sclerostin is human Sclerostin. In some embodiments, Sclerostin is cynomolgus Sclerostin.
  • the K off of the binding between the antibody moiety and Sclerostin is about 1 s -1 to about 10 -6 s -1 , about 1 s -1 to about 10 -2 s -1 , about 10 -2 s -1 to about 10 -3 s - 1 , about 10 -3 s -1 to about 10 -4 s -1 , about 10 -4 s -1 to about 10 -5 s -1 , about 10 -5 s -1 to about 10 -6 s -1 , about 1 s -1 to about 10 -5 s -1 , about 10 -2 s -1 to about 10 -6 s -1 , about 10 -3 s -1 to about 10 -6 s -1 , about 10 -4 s -1 to about 10 -6 s -1 , about 10 -2 s -1 to about 10 -5 s -1 , or about 10 -3 s -1 to about 10 -5 s -1 .
  • the K off of the binding between the antibody moiety and Sclerostin is at least about any one of 1 s -1 , 10 -2 s -1 , 10 -3 s -1 , 10 -4 s -1 , 10 -5 s -1 or 10 -6 s -1 .
  • Sclerostin is human Sclerostin. In some embodiments, Sclerostin is cynomolgus Sclerostin.
  • the binding affinity of the anti-Sclerostin antibody moiety or anti-Sclerostin construct are higher (for example, has a smaller K D value) than an existing anti-Sclerostin antibody (e.g., Romosozumab) .
  • the anti-Sclerostin construct (e.g., the anti-Sclerostin antibody moiety) is a chimeric antibody.
  • Certain chimeric antibodies are described, e.g., in U.S. Patent No. 4,816,567; and Morrison et al., Proc. Natl. Acad. Sci. USA, 81: 6851-6855 (1984) ) .
  • a chimeric antibody comprises a non-human variable region (e.g., a variable region derived from mouse) and a human constant region.
  • a chimeric antibody is a “class switched” antibody in which the class or subclass has been changed from that of the parent antibody. Chimeric antibodies include antigen-binding fragments thereof.
  • the anti-Sclerostin construct (e.g., the anti-Sclerostin antibody moiety) is a humanized antibody.
  • a non-human antibody is humanized to reduce immunogenicity to humans, while retaining the specificity and affinity of the parental non-human antibody.
  • a humanized antibody comprises one or more variable domains in which HVRs, e.g., CDRs, (or portions thereof) are derived from a non-human antibody, and FRs (or portions thereof) are derived from human antibody sequences.
  • a humanized antibody optionally will also comprise at least a portion of a human constant region.
  • some FR residues in a humanized antibody are substituted with corresponding residues from a non-human antibody (e.g., the antibody from which the HVR residues are derived) , e.g., to restore or improve antibody specificity or affinity.
  • a non-human antibody e.g., the antibody from which the HVR residues are derived
  • Human framework regions that may be used for humanization include but are not limited to: framework regions selected using the “best-fit” method (see, e.g., Sims et al. J. Immunol. 151: 2296 (1993) ) ; Framework regions derived from the consensus sequence of human antibodies of a particular subgroup of light or heavy chain variable regions (see, e.g., Carter et al. Proc. Natl. Acad. Sci. USA, 89: 4285 (1992) ; and Presta et al. J. Immunol., 151: 2623 (1993) ) ; human mature (somatically mutated) framework regions or human germline framework regions (see, e.g., Almagro and Fransson, Front.
  • mouse derived antibodies is a common and routinely used art. It is therefore understood that a humanized format of any and all of the anti-Sclerostin antibodies disclosed in Sequence Table can be used in a preclinical or clinical setting. In cases where a humanized format of any of the referenced anti-Sclerostin antibodies or their antigen-binding regions thereof is used in such a preclinical or clinical setting, the then humanized format is expected to bear the same or similar biological activities and profiles as the original non-humanized format.
  • the anti-Sclerostin construct (e.g., the anti-Sclerostin antibody moiety) is a human antibody (known as human domain antibody, or human dAb) .
  • Human antibodies can be produced using various techniques known in the art. Human antibodies are described generally in van Dijk and van de Winkel, Curr. Opin. Pharmacol. 5: 368-74 (2001) , Lonberg, Curr. Opin. Immunol. 20: 450-459 (2008) , and Chen, Mol. Immunol. 47 (4) : 912-21 (2010) . Transgenic mice or rats capable of producing fully human single-domain antibodies (or sdAb) are known in the art. See, e.g., US20090307787A1, U.S. Pat. No. 8,754,287, US20150289489A1, US20100122358A1, and WO2004049794.
  • Human antibodies may be prepared by administering an immunogen to a transgenic animal that has been modified to produce intact human antibodies or intact antibodies with human variable regions in response to antigenic challenge.
  • Such animals typically contain all or a portion of the human immunoglobulin loci, which replace the endogenous immunoglobulin loci, or which are present extrachromosomally or integrated randomly into the animal’s chromosomes.
  • the endogenous immunoglobulin loci have generally been inactivated.
  • Human variable regions from intact antibodies generated by such animals may be further modified, e.g., by combining with a different human constant region.
  • Human antibodies can also be made by hybridoma-based methods.
  • Human myeloma and mouse-human heteromyeloma cell lines for the production of human monoclonal antibodies have been described (See, e.g., Kozbor J. Immunol., 133: 3001 (1984) ; Brodeur et al., Monoclonal Antibody Production Techniques and Applications, pp. 51-63 (Marcel Dekker, Inc., New York, 1987) ; and Boerner et al., J. Immunol., 147: 86 (1991) ) .
  • Human antibodies generated via human B-cell hybridoma technology are also described in Li et al., Proc. Natl.
  • Human antibodies may also be generated by isolating Fv clone variable domain sequences selected from human-derived phage display libraries. Such variable domain sequences may then be combined with a desired human constant domain. Techniques for selecting human antibodies from antibody libraries are described below.
  • the anti-Sclerostin antibody moieties described herein may be isolated by screening combinatorial libraries for antibodies with the desired activity or activities. For example, a variety of methods are known in the art for generating phage display libraries and screening such libraries for antibodies possessing the desired binding characteristics. Such methods are reviewed, e.g., in Hoogenboom et al. in Methods in Molecular Biology 178: 1-37 (O’Brien et al., ed., Human Press, Totowa, NJ, 2001) and further described, e.g., in the McCafferty et al., Nature 348: 552-554; Clackson et al., Nature 352: 624-628 (1991) ; Marks et al., J.
  • repertoires of V H and V L genes are separately cloned by polymerase chain reaction (PCR) and recombined randomly in phage libraries, which can then be screened for antigen-binding phage as described in Winter et al., Ann. Rev. Immunol., 12: 433-455 (1994) .
  • Phage typically displays antibody fragments, either as scFv fragments or as Fab fragments.
  • Libraries from immunized sources provide high-affinity antibodies to the immunogen without the requirement of constructing hybridomas.
  • naive repertoire can be cloned (e.g., from human) to provide a single source of antibodies to a wide range of non-self and also self-antigens without any immunization as described by Griffiths et al., EMBO J, 12: 725-734 (1993) .
  • naive libraries can also be made synthetically by cloning unrearranged V-gene segments from stem cells, and using PCR primers containing random sequence to encode the highly variable CDR3 regions and to accomplish rearrangement in vitro, as described by Hoogenboom and Winter, J. Mol. Biol., 227: 381-388 (1992) .
  • Patent publications describing human antibody phage libraries include, for example: US Patent No. 5,750,373, and US Patent Publication Nos. 2005/0079574, 2005/0119455, 2005/0266000, 2007/0117126, 2007/0160598, 2007/0237764, 2007/0292936, and 2009/0002360.
  • Antibodies or antibody fragments isolated from human antibody libraries are considered human antibodies or human antibody fragments herein.
  • antibody variants having one or more amino acid substitutions are provided.
  • Sites of interest for substitutional mutagenesis include the HVRs (or CDRs) and FRs.
  • Conservative substitutions are shown in Table 2 under the heading of “Preferred substitutions. ” More substantial changes are provided in Table 2 under the heading of “exemplary substitutions, ” and as further described below in reference to amino acid side chain classes.
  • Amino acid substitutions may be introduced into an antibody of interest and the products screened for a desired activity, e.g., retained/improved antigen binding, decreased immunogenicity, or improved ADCC or CDC.
  • Amino acids may be grouped according to common side-chain properties: (1) hydrophobic: Norleucine, Met, Ala, Val, Leu, Ile; (2) neutral hydrophilic: Cys, Ser, Thr, Asn, Gln; (3) acidic: Asp, Glu; (4) basic: His, Lys, Arg; (5) residues that influence chain orientation: Gly, Pro; and (6) aromatic: Trp, Tyr, Phe.
  • Non-conservative substitutions will entail exchanging a member of one of these classes for another class.
  • substitutional variant involves substituting one or more hypervariable region residues of a parent antibody (e.g., a humanized or human antibody) .
  • a parent antibody e.g., a humanized or human antibody
  • the resulting variant (s) selected for further study will have modifications (e.g., improvements) in certain biological properties (e.g., increased affinity, reduced immunogenicity) relative to the parent antibody and/or will have substantially retained certain biological properties of the parent antibody.
  • An exemplary substitutional variant is an affinity matured antibody, which may be conveniently generated, e.g., using phage display-based affinity maturation techniques such as those described herein. Briefly, one or more HVR residues are mutated and the variant antibodies displayed on phage and screened for a particular biological activity (e.g. binding affinity) .
  • Alterations may be made in HVRs, e.g., to improve antibody affinity.
  • Such alterations may be made in HVR “hotspots, ” i.e., residues encoded by codons that undergo mutation at high frequency during the somatic maturation process (see, e.g., Chowdhury, Methods Mol. Biol. 207: 179-196 (2008) ) , and/or SDRs (a-CDRs) , with the resulting variant V H or V L being tested for binding affinity.
  • HVR “hotspots i.e., residues encoded by codons that undergo mutation at high frequency during the somatic maturation process (see, e.g., Chowdhury, Methods Mol. Biol. 207: 179-196 (2008) )
  • SDRs a-CDRs
  • affinity maturation diversity is introduced into the variable genes chosen for maturation by any of a variety of methods (e.g., error-prone PCR, chain shuffling, or oligonucleotide-directed mutagenesis) .
  • a secondary library is then created. The library is then screened to identify any antibody variants with the desired affinity.
  • Another method to introduce diversity involves HVR-directed approaches, in which several HVR residues (e.g., 4-6 residues at a time) are randomized. HVR residues involved in antigen binding may be specifically identified, e.g., using alanine scanning mutagenesis or modeling. CDR-H3 and CDR-L3 in particular are often targeted.
  • substitutions, insertions, or deletions may occur within one or more HVRs so long as such alterations do not substantially reduce the ability of the antibody to bind antigen.
  • conservative alterations e.g., conservative substitutions as provided herein
  • Such alterations may be outside of HVR “hotspots” or CDRs.
  • a useful method for identification of residues or regions of an antibody that may be targeted for mutagenesis is called “alanine scanning mutagenesis” as described by Cunningham and Wells (1989) Science, 244: 1081-1085.
  • a residue or group of target residues e.g., charged residues such as Arg, Asp, His, Lys, and Glu
  • a neutral or negatively charged amino acid e.g., alanine or polyalanine
  • Further substitutions may be introduced at the amino acid locations demonstrating functional sensitivity to the initial substitutions.
  • a crystal structure of an antigen-antibody complex to identify contact points between the antibody and antigen. Such contact residues and neighboring residues may be targeted or eliminated as candidates for substitution.
  • Variants may be screened to determine whether they contain the desired properties.
  • Amino acid sequence insertions include amino-and/or carboxyl-terminal fusions ranging in length from one residue to polypeptides containing a hundred or more residues, as well as intrasequence insertions of single or multiple amino acid residues.
  • terminal insertions include an antibody with an N-terminal methionyl residue.
  • Other insertional variants of the antibody molecule include the fusion to the N-or C-terminus of the antibody to an enzyme (e.g., for ADEPT) or a polypeptide which increases the serum half-life of the antibody.
  • the anti-Sclerostin construct e.g., the anti-Sclerostin antibody moiety
  • the anti-Sclerostin construct is altered to increase or decrease the extent to which the construct is glycosylated.
  • Addition or deletion of glycosylation sites to an antibody may be conveniently accomplished by altering the amino acid sequence such that one or more glycosylation sites is created or removed.
  • the carbohydrate attached thereto may be altered.
  • Native antibodies produced by mammalian cells typically comprise a branched, biantennary oligosaccharide that is generally attached by an N-linkage to Asn297 of the C H 2 domain of the Fc region. See, e.g., Wright et al. TIBTECH 15: 26-32 (1997) .
  • the oligosaccharide may include various carbohydrates, e.g., mannose, N-acetyl glucosamine (GlcNAc) , galactose, and sialic acid, as well as a fucose attached to a GlcNAc in the “stem” of the biantennary oligosaccharide structure.
  • modifications of the oligosaccharide in the antibody moiety may be made in order to create antibody variants with certain improved properties.
  • the anti-Sclerostin construct (e.g., the anti-Sclerostin antibody moiety) has a carbohydrate structure that lacks fucose attached (directly or indirectly) to an Fc region.
  • the amount of fucose in such antibody may be from 1%to 80%, from 1%to 65%, from 5%to 65%or from 20%to 40%.
  • the amount of fucose is determined by calculating the average amount of fucose within the sugar chain at Asn297, relative to the sum of all glycostructures attached to Asn 297 (e.g., complex, hybrid and high mannose structures) as measured by MALDI-TOF mass spectrometry, as described in WO 2008/077546, for example.
  • Asn297 refers to the asparagine residue located at about position 297 in the Fc region (EU numbering of Fc region residues) ; however, Asn297 may also be located about ⁇ 3 amino acids upstream or downstream of position 297, i.e., between positions 294 and 300, due to minor sequence variations in antibodies. Such fucosylation variants may have improved ADCC function. See, e.g., US Patent Publication Nos. US 2003/0157108 (Presta, L. ) ; US 2004/0093621 (Kyowa Hakko Kogyo Co., Ltd) .
  • Examples of publications related to “defucosylated” or “fucose-deficient” antibody variants include: US 2003/0157108; WO 2000/61739; WO 2001/29246; US 2003/0115614; US 2002/0164328; US 2004/0093621; US 2004/0132140; US 2004/0110704; US 2004/0110282; US 2004/0109865; WO 2003/085119; WO 2003/084570; WO 2005/035586; WO 2005/035778; WO2005/053742; WO2002/031140; Okazaki et al. J. Mol. Biol. 336: 1239-1249 (2004) ; Yamane-Ohnuki et al. Biotech.
  • Examples of cell lines capable of producing defucosylated antibodies include Lec13 CHO cells deficient in protein fucosylation (Ripka et al. Arch. Biochem. Biophys. 249: 533-545 (1986) ; US Patent Application No. US 2003/0157108 A1, Presta, L; and WO 2004/056312 A1, Adams et al., especially at Example 11) , and knockout cell lines, such as alpha-1, 6-fucosyltransferase gene, FUT8, knockout CHO cells (see, e.g., Yamane-Ohnuki et al. Biotech. Bioeng. 87: 614 (2004) ; Kanda, Y. et al., Biotechnol. Bioeng., 94 (4) : 680-688 (2006) ; and WO2003/085107) .
  • the anti-Sclerostin construct (e.g., the anti-Sclerostin antibody moiety) has bisected oligosaccharides, e.g., in which a biantennary oligosaccharide attached to the Fc region of the antibody is bisected by GlcNAc.
  • Such antibody variants may have reduced fucosylation and/or improved ADCC function. Examples of such antibody variants are described, e.g., in WO 2003/011878 (Jean-Mairet et al. ) ; US Patent No. 6,602,684 (Umana et al. ) ; and US 2005/0123546 (Umana et al. ) .
  • Antibody variants with at least one galactose residue in the oligosaccharide attached to the Fc region are also provided. Such antibody variants may have improved CDC function. Such antibody variants are described, e.g., in WO 1997/30087 (Patel et al. ) ; WO 1998/58964 (Raju, S. ) ; and WO 1999/22764 (Raju, S. ) .
  • the anti-Sclerostin construct (e.g., the anti-Sclerostin antibody moiety) comprises an Fc fragment.
  • Fc region, ” “Fc domain, ” “Fc fragment” or “Fc” refers to a C-terminal non-antigen binding region of an immunoglobulin heavy chain that contains at least a portion of the constant region.
  • the term includes native Fc regions and variant Fc regions.
  • a human IgG heavy chain Fc region extends from Cys226 to the carboxyl-terminus of the heavy chain.
  • the C-terminal lysine (Lys447) of the Fc region may or may not be present, without affecting the structure or stability of the Fc region.
  • numbering of amino acid residues in the IgG or Fc region is according to the EU numbering system for antibodies, also called the EU index, as described in Kabat et al., Sequences of Proteins of Immunological Interest, 5th Ed. Public Health Service, National Institutes of Health, Bethesda, MD, 1991.
  • the Fc fragment is from an immunoglobulin selected from the group consisting of IgG, IgA, IgD, IgE, IgM, and combinations and hybrids thereof. In some embodiments, the Fc fragment is from an immunoglobulin selected from the group consisting of IgG1, IgG2, IgG3, IgG4, and combinations and hybrids thereof.
  • the Fc fragment has a reduced effector function as compared to corresponding wildtype Fc fragment (such as at least about 30%, 40%, 50%, 60%, 70%, 80%, 85%, 90%, or 95%reduced effector function as measured by the level of antibody-dependent cellular cytotoxicity (ADCC) ) .
  • ADCC antibody-dependent cellular cytotoxicity
  • the Fc fragment is an IgG1 Fc fragment. In some embodiments, the IgG1 Fc fragment comprises a L234A mutation and/or a L235A mutation. In some embodiments, the Fc fragment is an IgG2 or IgG4 Fc fragment. In some embodiments, the Fc fragment is an IgG4 Fc fragment comprising a S228P, F234A, and/or a L235A mutation. In some embodiments, the Fc fragment comprises a N297A mutation. In some embodiments, the Fc fragment comprises a N297G mutation.
  • one or more amino acid modifications may be introduced into the Fc region of the antibody moiety, thereby generating an Fc region variant.
  • the Fc region variant may comprise a human Fc region sequence (e.g., a human IgG1, IgG2, IgG3 or IgG4 Fc region) comprising an amino acid modification (e.g. a substitution) at one or more amino acid positions.
  • the Fc fragment is derived from a rat Fc region sequence (e.g., a rat IgG2 Fc) or a mouse Fc region sequence (e.g., a mouse IgG1 Fc) .
  • the Fc fragment comprises a human IgG2 Fc region.
  • the Fc fragment comprises a human IgG4 Fc region.
  • the Fc fragment comprises a modified human IgG4 heavy chain Fc region comprising one or more (such as two, three, or four) substitutions selected from the group consisting of S228P, T366W, and optional H435R, and optional Y436F.
  • the numberings of the modifications described herein are according to the EU index unless otherwise noted.
  • the Fc fragment comprises a modified human IgG4 heavy chain Fc region comprising S228P, T366W, and optional H435R, and optional Y436F.
  • the Fc fragment comprises a modified human IgG4 heavy chain Fc region comprising one or more (such as two, three, four, five or six) substitutions selected from the group consisting of F126C, L128C, C131S, F170C, P161C, V173C, S228P, T366S, L368A, and Y407V, and optional H435R, and optional Y436F.
  • the Fc fragment comprises a modified human IgG4 heavy chain Fc region comprising a) C131S, S228P, T366S, L368A, and Y407V, and b) one of the substitutions selected from the group consisting of F126C, L128C, F170C, P161C, and V173C, and c) optional H435R, and optional Y436F.
  • the Fc fragment comprises a modified human IgG4 heavy chain Fc region comprising one or more (such as two, three, four, five or six) substitutions selected from the group consisting of F126C, C131S, S228P, T366S, L368A, and Y407V, and optional H435R, and optional Y436F.
  • the Fc fragment comprises a modified human IgG4 heavy chain Fc region comprising F126C, C131S, S228P, T366S, L368A, and Y407V, and optional H435R, and optional Y436F.
  • the Fc fragment comprises a modified human IgG4 heavy chain Fc region comprising L128C, C131S, S228P, T366S, L368A, and Y407V, and optional H435R, and optional Y436F. In some embodiments, the Fc fragment comprises a modified human IgG4 heavy chain Fc region comprising C131S, F170C, S228P, T366S, L368A, and Y407V, and optional H435R, and optional Y436F.
  • the Fc fragment comprises a modified human IgG4 heavy chain Fc region comprising C131S, V173C, S228P, T366S, L368A, and Y407V, and optional H435R, and optional Y436F. In some embodiments, the Fc fragment comprises a modified human IgG4 heavy chain Fc region comprising C131S, P171C, S228P, T366S, L368A, and Y407V, and optional H435R, and optional Y436F.
  • the anti-Sclerostin construct comprises a Fc fragment comprising a) a first modified human IgG4 heavy chain Fc region comprising S228P, T366W, and b) a second modified human IgG4 heavy chain Fc region comprising a) C131S, S228P, T366S, L368A, and Y407V, and optional H435R, and optional Y436F, and b) one of the substitutions selected from the group consisting of F126C, L128C, F170C, P161C, and V173C.
  • the anti-Sclerostin construct comprises a Fc fragment comprising a) a first modified human IgG4 heavy chain Fc region comprising S228P, T366W, and b) a second modified human IgG4 heavy chain Fc region comprising F126C, C131S, S228P, T366S, L368A, Y407V, H435R, and Y436F.
  • the anti-Sclerostin construct comprises a Fc fragment comprising a) a first modified human IgG4 heavy chain Fc region comprising S228P, T366W, and b) a second modified human IgG4 heavy chain Fc region comprising L128C, C131S, S228P, T366S, L368A, Y407V, H435R, and Y436F.
  • the anti-Sclerostin construct comprises a Fc fragment comprising a) a first modified human IgG4 heavy chain Fc region comprising S228P, T366W, and b) a second modified human IgG4 heavy chain Fc region comprising C131S, F170C, S228P, T366S, L368A, Y407V, H435R, and Y436F.
  • the anti-Sclerostin construct comprises a Fc fragment comprising a) a first modified human IgG4 heavy chain Fc region comprising S228P, T366W, and b) a second modified human IgG4 heavy chain Fc region comprising C131S, V173C, S228P, T366S, L368A, Y407V, H435R, and Y436F.
  • the anti-Sclerostin construct comprises a Fc fragment comprising a) a first modified human IgG4 heavy chain Fc region comprising S228P, T366W, and b) a second modified human IgG4 heavy chain Fc region comprising C131S, P171C, S228P, T366S, L368A, Y407V, H435R, and Y436F.
  • the anti-Sclerostin construct comprises a human Ig kappa light chain constant region. In some embodiments, the anti-Sclerostin construct comprises a modified human Ig kappa light chain constant region comprising F118C, S121C, Q160C, S162C, S176C, and/or C214S. In some embodiments, the anti-Sclerostin construct comprises a modified human Ig kappa light chain constant region comprising S121C and C214S. In some embodiments, the anti-Sclerostin construct comprises a modified human Ig kappa light chain constant region comprising F118C and C214S.
  • the anti-Sclerostin construct comprises a modified human Ig kappa light chain constant region comprising S176C and C214S. In some embodiments, the anti-Sclerostin construct comprises a modified human Ig kappa light chain constant region comprising Q160C and C214S. In some embodiments, the anti-Sclerostin construct comprises a modified human Ig kappa light chain constant region comprising S162C and C214S.
  • the Fc fragment possesses some but not all effector functions, which make it a desirable candidate for applications in which the half-life of the antibody moiety in vivo is important yet certain effector functions (such as complement and ADCC) are unnecessary or deleterious.
  • In vitro and/or in vivo cytotoxicity assays can be conducted to confirm the reduction/depletion of CDC and/or ADCC activities.
  • Fc receptor (FcR) binding assays can be conducted to ensure that the antibody lacks Fc ⁇ R binding (hence likely lacking ADCC activity) , but retains FcRn binding ability.
  • NK cells express Fc ⁇ RIII only, whereas monocytes express Fc ⁇ RI, Fc ⁇ RII and Fc ⁇ RIII.
  • FcR expression on hematopoietic cells is summarized in Table 2 on page 464 of Ravetch and Kinet, Annu. Rev. Immunol. 9: 457-492 (1991) .
  • Non-limiting examples of in vitro assays to assess ADCC activity of a molecule of interest is described in U.S. Patent No. 5,500,362 (see, e.g. Hellstrom, I. et al. Proc. Nat’l Acad. Sci. USA 83: 7059-7063 (1986) ) and Hellstrom, I et al., Proc.
  • non-radioactive assays methods may be employed (see, for example, ACTI TM non-radioactive cytotoxicity assay for flow cytometry (CellTechnology, Inc. Mountain View, CA; and CytoTox non-radioactive cytotoxicity assay (Promega, Madison, WI) .
  • Useful effector cells for such assays include peripheral blood mononuclear cells (PBMC) and Natural Killer (NK) cells.
  • ADCC activity of the molecule of interest may be assessed in vivo, e.g., in an animal model such as that disclosed in Clynes et al. Proc. Nat’l Acad. Sci. USA 95: 652-656 (1998) .
  • C1q binding assays may also be carried out to confirm that the antibody is unable to bind C1q and hence lacks CDC activity. See, e.g., C1q and C3c binding ELISA in WO 2006/029879 and WO 2005/100402.
  • a CDC assay may be performed (see, for example, Gazzano- Santoro et al., J. Immunol.
  • FcRn binding and in vivo clearance/half-life determinations can also be performed using methods known in the art (see, e.g., Petkova, S.B. et al., Int’l. Immunol. 18 (12) : 1759-1769 (2006) ) .
  • Antibodies with reduced effector function include those with substitution of one or more of Fc region residues 238, 265, 269, 270, 297, 327 and 329 (U.S. Patent No. 6,737,056) .
  • Such Fc mutants include Fc mutants with substitutions at two or more of amino acid positions 265, 269, 270, 297 and 327, including the so-called “DANA” Fc mutant with substitution of residues 265 and 297 to alanine (US Patent No. 7,332,581) .
  • the Fc fragment comprises a N297A mutation.
  • the Fc fragment comprises a N297G mutation.
  • the Fc fragment is an IgG1 Fc fragment. In some embodiments, the IgG1 Fc fragment comprises a L234A mutation and/or a L235A mutation. In some embodiments, the Fc fragment is an IgG2 or IgG4 Fc fragment. In some embodiments, the Fc fragment is an IgG4 Fc fragment comprising a S228P, F234A, and/or a L235A mutation.
  • the antibody moiety comprises an Fc region with one or more amino acid substitutions which improve ADCC, e.g., substitutions at positions 298, 333, and/or 334 of the Fc region (EU numbering of residues) .
  • alterations are made in the Fc region that result in altered (i.e., either improved or diminished) C1q binding and/or Complement Dependent Cytotoxicity (CDC) , e.g., as described in US Patent No. 6,194,551, WO 99/51642, and Idusogie et al. J. Immunol. 164: 4178-4184 (2000) .
  • CDC Complement Dependent Cytotoxicity
  • the antibody moiety variant comprising a variant Fc region comprising one or more amino acid substitutions which alters half-life and/or changes binding to the neonatal Fc receptor (FcRn) .
  • Antibodies with increased half-lives and improved binding to the neonatal Fc receptor (FcRn) which is responsible for the transfer of maternal IgGs to the fetus (Guyer et al., J. Immunol. 117: 587 (1976) and Kim et al., J. Immunol. 24: 249 (1994) ) , are described in US2005/0014934A1 (Hinton et al. ) .
  • Those antibodies comprise an Fc region with one or more substitutions therein which alters binding of the Fc region to FcRn.
  • Fc variants include those with substitutions at one or more of Fc region residues at positions 250, 252, 254, 256, 307, 308, 428, 434 (US Patent No. 7,371,826) , including the so-called “LS” Fc mutant comprising M428L and N434S (WO 2009/086320) , and so-called “YTE” Fc mutant comprising M252Y, S254T and T256E (WO 2002/060919) .
  • cysteine engineered antibody moieties e.g., “thioMAbs, ” in which one or more residues of an antibody are substituted with cysteine residues.
  • the substituted residues occur at accessible sites of the antibody.
  • reactive thiol groups are thereby positioned at accessible sites of the antibody and may be used to conjugate the antibody to other moieties, such as drug moieties or linker-drug moieties, to create an antibody-drug conjugate, as described further herein.
  • any one or more of the following residues may be substituted with cysteine: A118 (EU numbering) of the heavy chain; and S400 (EU numbering) of the heavy chain Fc region.
  • Cysteine engineered antibody moieties may be generated as described, e.g., in U.S. Patent No. 7,521,541.
  • the antibody moiety described herein may be further modified to comprise additional nonproteinaceous moieties that are known in the art and readily available.
  • the moieties suitable for derivatization of the antibody include but are not limited to water soluble polymers.
  • water soluble polymers include, but are not limited to, polyethylene glycol (PEG) , copolymers of ethylene glycol/propylene glycol, carboxymethylcellulose, dextran, polyvinyl alcohol, polyvinyl pyrrolidone, poly-1, 3-dioxolane, poly-1, 3, 6-trioxane, ethylene/maleic anhydride copolymer, polyaminoacids (either homopolymers or random copolymers) , and dextran or poly (n-vinyl pyrrolidone) polyethylene glycol, propropylene glycol homopolymers, prolypropylene oxide/ethylene oxide co-polymers, polyoxyethylated polyols (e.g.
  • Polyethylene glycol propionaldehyde may have advantages in manufacturing due to its stability in water.
  • the polymer may be of any molecular weight, and may be branched or unbranched.
  • the number of polymers attached to the antibody may vary, and if more than one polymer are attached, they can be the same or different molecules. In general, the number and/or type of polymers used for derivatization can be determined based on considerations including, but not limited to, the particular properties or functions of the antibody to be improved, whether the antibody derivative will be used in diagnosis under defined conditions, etc.
  • the antibody moiety may be further modified to comprise one or more biologically active protein, polypeptides or fragments thereof.
  • Bioactive or “biologically active” , as used herein interchangeably, means showing biological activity in the body to carry out a specific function. For example, it may mean the combination with a particular biomolecule such as protein, DNA, etc., and then promotion or inhibition of the activity of such biomolecule.
  • the bioactive protein or fragments thereof include proteins and polypeptides that are administered to patients as the active drug substance for prevention of or treatment of a disease or condition, as well as proteins and polypeptides that are used for diagnostic purposes, such as enzymes used in diagnostic tests or in vitro assays, as well as proteins and polypeptides that are administered to a patient to prevent a disease such as a vaccine.
  • the anti-Sclerostin constructs in some embodiments comprise a multispecific (e.g., bispecific) anti-Sclerostin construct comprising an anti-Sclerostin antibody moiety according to any one of the anti-Sclerostin antibody moieties described herein, and a second binding moiety (such as a second antibody moiety) specifically recognizing a second antigen.
  • the multispecific anti-Sclerostin molecule comprises an anti-Sclerostin antibody moiety and a second antibody moiety specifically recognizing a second antigen.
  • the second antigen is an immune checkpoint molecule.
  • the second antigen is DKK1 (Dickkopf WNT Signaling Pathway Inhibitor 1) or RANKL (Receptor Activator of NF- ⁇ B Ligand) .
  • the present application provides multispecific constructs targeting both Sclerostin and RANKL.
  • a multispecific construct comprising a first antibody moiety that specifically recognizes Sclerostin and a second antibody moiety that specifically recognizes RANKL.
  • the Sclerostin is a human Sclerostin.
  • the RANKL is a human RANKL.
  • RANKL Receptor activator of nuclear factor kappa- ⁇ ligand
  • TNFSF11 tumor necrosis factor ligand superfamily member 11
  • This protein was shown to be a dendritic cell survival factor and is involved in the regulation of T cell-dependent immune response. T cell activation was reported to induce expression of this gene and lead to an increase of osteoclastogenesis and bone loss.
  • This protein was shown to activate antiapoptotic kinase AKT/PKB through a signaling complex involving SRC kinase and tumor necrosis factor receptor-associated factor (TRAF6) , which indicated this protein may have a role in the regulation of cell apoptosis.
  • Targeted disruption of the related gene in mice led to severe osteopetrosis and a lack of osteoclasts.
  • the deficient mice exhibited defects in early differentiation of T and B lymphocytes, and failed to form lobulo-alveolar mammary structures during pregnancy.
  • the anti-RANKL antibody moiety (such as an scFv) used in multispecific anti-Sclerostin constructs described herein comprises an antibody moiety comprising a heavy chain variable region (V H ) and a light chain variable region (V L ) , wherein the antibody moiety competes for a binding epitope of RANKL with an antibody or antibody fragment comprising a second heavy variable region (V H-2 ) and a second light chain variable region (V L-2 ) , wherein the V H-2 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 66, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 67, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 68, and the V L-2 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 69, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 70, and the LC
  • the anti-RANKL antibody moiety (such as an scFv) used in multispecific anti-Sclerostin constructs comprises an antibody moiety comprising a heavy chain variable region (V H ) and a light chain variable region (V L ) , wherein the V H comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 66, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 67, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 68, and the V L comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 69, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 70, and the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 71.
  • V H comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 66
  • the HC-CDR2 comprising the amino acid sequence of SEQ ID NO
  • the V H comprises an amino acid sequence of SEQ ID NO: 72, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity; and the V L comprises an amino acid sequence of SEQ ID NO: 73, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity.
  • the anti-RANKL moiety comprises a HC-CDR1, a HC-CDR2, and a HC-CDR3, respectively comprising the amino acid sequences of a CDR1, a CDR2, and a CDR3 within a V H chain region having the sequence set forth in SEQ ID NO: 72; and a LC-CDR1, a LC-CDR2, and a LC-CDR3, respectively comprising the amino acid sequences of a CDR1, a CDR2, and a CDR3 within a V L chain region having the sequence set forth in SEQ ID NO: 73.
  • a multispecific construct comprising a first antibody moiety that specifically recognizes RANKL and a second antibody moiety that specifically recognizes Sclerostin, wherein the first antibody moiety comprises an anti-RANKL single domain antibody (sdAb) moiety, and wherein the second antibody moiety comprises a full-length antibody comprising a heavy chain variable region (V H ) and a second light chain variable region (V L ) and an Fc fragment.
  • the anti-RANKL sdAb is fused to both of the heavy chains of the full-length antibody comprising an Fc fragment.
  • the anti-RANKL sdAb is fused to both of the light chains of the full-length antibody.
  • the anti-RANKL sdAb is fused to N-terminus of both heavy or light chains of the full-length antibody. In some embodiments, the anti-RANKL sdAb is fused to C-terminus of both heavy or light chains of the full-length antibody. In some embodiments, the anti-RANKL sdAb is fused to the full-length antibody via a linker (such as any of the linkers described herein) . In some embodiments, the anti-RANKL sdAb is fused to the full-length antibody without a linker.
  • a multispecific construct comprising a first antibody moiety that specifically recognizes RANKL and a second antibody moiety that specifically recognizes Sclerostin, wherein the first antibody moiety comprises an anti-RANKL single domain antibody (sdAb) moiety, wherein the second antibody moiety comprises a heavy chain variable region (V H ) and a second light chain variable region (V L ) , wherein the construct comprises: a) two chimeric heavy chains each comprising, from N-terminus to C-terminus, the i) the V H , ii) a first heavy chain constant domain ( “C H 1 domain” ) , iii) the anti-RANKL sdAb, and iv) an Fc domain, wherein the two Fc domains form an Fc fragment; b) two light chains comprising the V L and a light chain constant domain ( “C L domain” ) .
  • the anti-RANKL sdAb is fused to the Fc
  • a multispecific construct comprising a first antibody moiety that specifically recognizes RANKL and a second antibody moiety that specifically recognizes Sclerostin, wherein the first antibody moiety comprises an anti-RANKL single domain antibody (sdAb) moiety, wherein the second antibody moiety comprises a heavy chain variable region (V H ) and a second light chain variable region (V L ) , and wherein the construct comprises: a) a first heavy chain comprising, from N-terminus to C-terminus, i) the anti-RANKL sdAb, and ii) a first Fc domain; b) a second heavy chain comprising, from N-terminus to C-terminus, i) the V H , ii) a first heavy chain constant domain ( “C H 1 domain” ) , and iii) a second Fc domain; and c) a light chain comprising the V L and a light chain constant domain ( “C L domain” ) , where
  • one of the first and the second Fc domains comprises a T366W mutation, and optionally a S354C mutation, and wherein the other Fc domain comprises a T366S mutation, a L368A mutation, a Y407V mutation, and optionally a Y349C mutation.
  • the second antibody moiety competes for a binding epitope of RANKL with a third antibody moiety comprising a second heavy chain variable region (V H-2 ) and a second light chain variable region (V L-2 )
  • V H-2 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 66
  • the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 67
  • the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 68
  • the V L-2 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 69
  • the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 70
  • the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 71.
  • the V H comprises a HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 66, a HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 67, and a HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 68
  • the V L comprises a LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 69, a LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 70, and a LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 71.
  • the anti-Sclerostin construct is a multispecific (e.g., bispecific) anti-Sclerostin construct comprising a) an anti-Sclerostin antibody moiety according to any one of the anti-Sclerostin antibody moieties described herein; b) a second antibody moiety specifically recognizing RANKL (an anti-RANKL antibody moiety such as any of the anti-RANKL antibody moieties described herein) .
  • RANKL an anti-RANKL antibody moiety such as any of the anti-RANKL antibody moieties described herein
  • the anti-Sclerostin V H comprises i) the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 1, ii) the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 5, and iii) the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 9, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the HC-CDRs
  • the anti-Sclerostin V L comprises i) the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 15, ii) the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and iii) the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 20, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the LC-CDRs.
  • the anti-Sclerostin V H comprises i) the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 1, ii) the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 5, and iii) the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 9, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the HC-CDRs
  • the anti-Sclerostin V L comprises i) the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 85, ii) the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and iii) the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 20, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the LC-CDRs.
  • amino acid substitutions described above are limited to “exemplary substitutions” shown in Table 2 of this application. In some embodiments, the amino acid substitutions are limited to “preferred substitutions” shown in Table 2 of this application.
  • the anti-Sclerostin construct is a multispecific (e.g., bispecific) anti-Sclerostin construct comprising a) an anti-Sclerostin full-length antibody comprising two heavy chains and two light chains, wherein the two heavy chains each comprises a heavy chain variable region (V H ) and the two light chains each comprises a light chain variable region (V L ) , b) an anti-RANKL antibody moiety (such as any of the antibody moiety described herein) fused to at least both of the heavy chains of the anti-Sclerostin full-length antibody.
  • the anti-RANKL antibody moiety is fused to N-terminus of both heavy chains.
  • the anti-RANKL antibody moiety is fused to C-terminus of both heavy chains.
  • the anti-Sclerostin construct is a multispecific (e.g., bispecific) anti-Sclerostin construct comprising a) an anti-RANKL antibody moiety comprising a full-length antibody comprising two heavy chains and two light chains, wherein the two heavy chains each comprises a heavy chain variable region (V H ) and the two light chains each comprises a light chain variable region (V L ) , b) an anti-Sclerostin antibody moiety (such as any of the anti-Sclerostin antibody moiety described herein) fused to at least one or both of the heavy chains of the anti-RANKL full-length antibody.
  • the anti-Sclerostin antibody moiety is fused to N-terminus of both heavy chains.
  • the anti-Sclerostin antibody moiety is fused to C-terminus of both heavy chains.
  • the anti-Sclerostin construct is a multispecific (e.g., bispecific) anti-Sclerostin construct comprising a) an anti-Sclerostin full-length antibody comprising two heavy chains and two light chains, wherein the two heavy chains each comprises a heavy chain variable region (V H ) and the two light chains each comprises a light chain variable region (V L ) , b) an anti-RANKL antibody moiety (such as any of the antibody moiety described herein) fused to at least both of the light chains of the anti-Sclerostin full-length antibody.
  • the anti-RANKL antibody moiety is fused to N-terminus of both light chains.
  • the anti-RANKL antibody moiety is fused to C-terminus of both light chains.
  • a multispecific construct comprising a first antibody moiety that specifically recognizes Sclerostin and a second antibody moiety that specifically recognizes RANKL, wherein the first antibody moiety comprises single chain Fv fragment (scFv) comprising a first heavy chain variable region (V H-1 ) and a first light chain variable region (V L-1 ) , and wherein the second antibody moiety is a full-length antibody comprising a second heavy chain variable region (V H-2 ) , a second light chain variable region (V L- 2 ) and an Fc fragment.
  • the first antibody moiety is fused to one or both of the heavy chains of the full-length antibody.
  • the first antibody moiety is fused to one or both of the light chains of the full-length antibody. In some embodiments, the first antibody moiety is fused to N-terminus of the one or both of the heavy chains or light chains of the full-length antibody. In some embodiments, the first antibody moiety is fused to C-terminus of the one or both of the heavy chains or light chains of the full-length antibody. In some embodiments, the first antibody moiety is fused to the full-length antibody via a first linker (such as any of the linkers described herein) . In some embodiments, the first antibody moiety is fused to the full-length antibody without a linker. In some embodiments, the V H-1 is fused with the V L-1 via a second linker (such as any of the linkers described herein) .
  • a multispecific construct comprising a first antibody moiety that specifically recognizes Sclerostin and a second antibody moiety that specifically recognizes RANKL, wherein the first antibody moiety is a full-length antibody comprising a first heavy chain variable region (V H-1 ) , a first light chain variable region (V L-1 ) and an Fc fragment, and wherein the second antibody moiety comprises single chain Fv fragment (scFv) comprising a second heavy chain variable region (V H-2 ) and a second light chain variable region (V L-2 ) .
  • the second antibody moiety is fused to both of the heavy chains of the full-length antibody.
  • the second antibody moiety is fused to both of the light chains of the full-length antibody. In some embodiments, the second antibody moiety is fused to N-terminus of both of the heavy chains or light chains of the full-length antibody. In some embodiments, the second antibody moiety is fused to C-terminus of the both of the heavy chains or light chains of the full-length antibody. In some embodiments, the second antibody moiety is fused to the full-length antibody via a first linker (such as any of the linkers described herein) . In some embodiments, the second antibody moiety is fused to the full-length antibody without a linker.
  • a first linker such as any of the linkers described herein
  • the V H-2 is fused with the V L-2 via a second linker (such as any of the linkers described herein) , to enable correct scFv assembling. In some embodiments, the V H-2 is fused with the V L-2 without a linker.
  • a multispecific construct specifically recognizing Sclerostin and RANKL, comprising a first antibody moiety and a second antibody, wherein the first antibody moiety comprises a first heavy chain variable region (V H-1 ) and a first light chain variable region (V L-1 ) , and wherein the second antibody moiety comprises a second heavy chain variable region (V H-2 ) and a second light chain variable region (V L-2 ) , wherein the construct comprises: a) a first polypeptide comprising a first light chain comprising, from N-terminus to C-terminus, i) the V L-1 , ii) a first light chain constant domain ( “first CL domain” ) ; b) a second polypeptide comprising a first heavy chain, from N-terminus to C-terminus, i) the V H-1 , ii) a first heavy chain constant domain ( “first CH1 domain” ) , and iii) a first Fc domain; c
  • the first antibody moiety specifically recognizes Sclerostin
  • the second antibody moiety specifically recognizes RANKL
  • the first antibody moiety specifically recognizes RANKL
  • the second antibody moiety specifically recognizes Sclerostin.
  • one of the first and the second Fc domains comprises a T366W mutation, and optionally a S354C mutation, and wherein the other Fc domain comprises a T366S mutation, a L368A mutation, a Y407V mutation, and optionally a Y349C mutation, wherein numbering is according to the EU index.
  • either i) the first CH1 domain and the first CL domain or ii) the second CH1 domain and the second CL domain are selected from the group consisting of: a) a CH1 domain wherein the amino acid at position 141 is substituted for cysteine and the cysteine at position 131 (e.g., in IgG2 or IgG4) or 220 (e.g., in IgG1) is substituted for a non-cysteine amino acid; and a CL domain wherein the amino acid at position 116 is substituted for cysteine and the cysteine at position 214 is substituted for a non-cysteine amino acid; b) a CH1 domain wherein the amino acid at position 168 is substituted for cysteine and the cysteine position 131 (e.g., in IgG2 or IgG4) or 220 (e.g., in IgG1) is substituted for a non-cysteine amino acid; and a CL domain wherein the amino acid at position
  • a multispecific construct comprising a first antibody moiety that specifically recognizes Sclerostin and a second antibody moiety that specifically recognizes RANKL, wherein the first antibody moiety is an anti-Sclerostin full-length antibody comprising two heavy chains and two light chains, wherein the two heavy chains each comprises a first heavy chain variable region (V H-1 ) , wherein the two light chains each comprises a first light chain variable region (V L-1 ) , and wherein the second antibody moiety comprises an anti-RANKL single chain Fv fragment (scFv) comprising a second heavy chain variable region (V H-2 ) and a second light chain variable region (V L-2 ) , wherein the second antibody moiety is fused to C-terminus of both heavy chains of the anti-Sclerostin full-length antibody.
  • the first antibody moiety is an anti-Sclerostin full-length antibody comprising two heavy chains and two light chains
  • the two heavy chains each comprises a first heavy chain variable region (V H-1 )
  • the V H-1 comprises an amino acid sequence of SEQ ID NO: 22, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity; and the V L-1 comprises an amino acid sequence of SEQ ID NO: 23, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity.
  • the V H-2 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 66, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 67, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 68
  • the V L-2 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 69, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 70, and the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 71.
  • the V H-2 comprises an amino acid sequence of SEQ ID NO: 72, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity; and the V L-1 comprises an amino acid sequence of SEQ ID NO: 73, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity.
  • a multispecific construct specifically recognizing Sclerostin and RANKL, comprising a first antibody moiety and a second antibody, wherein the first antibody moiety comprises a first heavy chain variable region (V H-1 ) and a first light chain variable region (V L-1 ) , and wherein the second antibody moiety comprises a second heavy chain variable region (V H-2 ) and a second light chain variable region (V L-2 ) , wherein the construct comprises: a) a first polypeptide comprising a first light chain comprising, from N-terminus to C-terminus, i) the V L-1 , ii) a first light chain constant domain ( “first CL domain” ) ; b) a second polypeptide comprising a first heavy chain, from N-terminus to C-terminus, i) the V H-1 , ii) a first heavy chain constant domain ( “first CH1 domain” ) , and iii) a first Fc domain; c
  • the V H-1 comprises an amino acid sequence of SEQ ID NO: 22, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity; and the V L-1 comprises an amino acid sequence of SEQ ID NO: 23, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity.
  • the V H-2 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 66, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 67, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 68
  • the V L-2 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 69, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 70, and the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 71.
  • the V H-2 comprises an amino acid sequence of SEQ ID NO: 72, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity; and the V L-1 comprises an amino acid sequence of SEQ ID NO: 73, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity.
  • a multispecific (e.g., bispecific) construct comprising a) a first heavy chain comprising a first variable heavy chain variable region (V H-1 ) and a first heavy chain constant region, wherein the first heavy chain comprises an amino acid sequence of SEQ ID NO: 134; b) a first light chain comprising a first light chain variable region (V L-1 ) and a first light chain constant region, wherein the first light chain comprises an amino acid sequence of SEQ ID NO: 135; c) a second heavy chain comprising a second variable heavy chain variable region (V H-2 ) and a second heavy chain constant region, wherein the second heavy chain comprises the amino acid sequence of SEQ ID NO: 156; and d) a second light chain comprising a second light chain variable region (V L-2 ) and a second light chain constant region, wherein the second light chain comprises the amino acid sequence of SEQ ID NO: 157, wherein the V H-1 and the V L-1 comprises a first antibody moiety specifically
  • a multispecific (e.g., bispecific) construct comprising a) a first heavy chain comprising a first variable heavy chain variable region (V H-1 ) and a first heavy chain constant region, wherein the first heavy chain comprises an amino acid sequence of SEQ ID NO: 134; b) a first light chain comprising a first light chain variable region (V L-1 ) and a first light chain constant region, wherein the first light chain comprises an amino acid sequence of SEQ ID NO: 135; c) a second heavy chain comprising a second variable heavy chain variable region (V H-2 ) and a second heavy chain constant region, wherein the second heavy chain comprises the amino acid sequence of SEQ ID NO: 158; and d) a second light chain comprising a second light chain variable region (V L-2 ) and a second light chain constant region, wherein the second light chain comprises the amino acid sequence of SEQ ID NO: 159, wherein the V H-1 and the V L-1 comprises a first antibody moiety specifically
  • the V H-1 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 1, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 5, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 9; and the V L-1 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 15, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and the LC-CDR3 comprising the amino acid sequence of any one of SEQ ID NOs: 20.
  • the V L-1 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 15, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and the LC-CDR3 comprising the amino acid sequence of any one of SEQ ID NOs: 20.
  • a multispecific (e.g., bispecific) construct comprising a) a first heavy chain comprising a first variable heavy chain variable region (V H-1 ) and a first heavy chain constant region, wherein the first heavy chain comprises an amino acid sequence of SEQ ID NO: 134; b) a first light chain comprising a first light chain variable region (V L-1 ) and a first light chain constant region, wherein the first light chain comprises an amino acid sequence of SEQ ID NO: 135; c) a second heavy chain comprising a second variable heavy chain variable region (V H-2 ) and a second heavy chain constant region, wherein the second heavy chain comprises the amino acid sequence of SEQ ID NO: 160; and d) a second light chain comprising a second light chain variable region (V L-2 ) and a second light chain constant region, wherein the second light chain comprises the amino acid sequence of SEQ ID NO: 161, wherein the V H-1 and the V L-1 comprises a first antibody moiety specifically recognizing
  • a multispecific (e.g., bispecific) construct comprising a) a first heavy chain comprising a first variable heavy chain variable region (V H-1 ) and a first heavy chain constant region, wherein the first heavy chain comprises an amino acid sequence of SEQ ID NO: 134; b) a first light chain comprising a first light chain variable region (V L-1 ) and a first light chain constant region, wherein the first light chain comprises an amino acid sequence of SEQ ID NO: 135; c) a second heavy chain comprising a second variable heavy chain variable region (V H-2 ) and a second heavy chain constant region, wherein the second heavy chain comprises the amino acid sequence of SEQ ID NO: 162; and d) a second light chain comprising a second light chain variable region (V L-2 ) and a second light chain constant region, wherein the second light chain comprises the amino acid sequence of SEQ ID NO: 163, wherein the V H-1 and the V L-1 comprises a first antibody moiety specifically
  • a multispecific (e.g., bispecific) anti-Sclerostin construct comprising a) a first antibody moiety that specifically recognizes Sclerostin comprising a first heavy chain variable region (V H-1 ) and a first light chain variable region (V L-1 )
  • the V H-1 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 1, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 5, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 9
  • the V L-1 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 15, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 20, and b) a second antibody moiety that specifically recognizes RANKL comprising a second heavy chain variable region (V H-2 ) and a second light chain variable region
  • the V H-1 comprises an amino acid sequence of SEQ ID NO: 22, and the V L-1 comprises an amino acid sequence of SEQ ID NO: 23. In some embodiments, the V H-1 comprises an amino acid sequence of SEQ ID NO: 87 or 168, and the V L- 1 comprises an amino acid sequence of SEQ ID NO: 88 or 169. In some embodiments, the V H-1 comprises an amino acid sequence of SEQ ID NO: 87, and the V L-1 comprises an amino acid sequence of SEQ ID NO: 88. In some embodiments, the V H-1 comprises an amino acid sequence of SEQ ID NO: 168, and the V L-1 comprises an amino acid sequence of SEQ ID NO: 169.
  • the V H-2 comprises an amino acid sequence of SEQ ID NO: 72
  • the V L-2 comprises an amino acid sequence of SEQ ID NO: 73.
  • the first antibody moiety is a full-length antibody comprising two heavy chains and two light chains
  • the second antibody moiety is a scFv comprising the V H-2 and V L-2 .
  • the V H-2 is fused to the N-terminus of the V L-2 .
  • the V H-2 is fused to the C-terminus of the V L-2 optionally with a single alanine amino acid appended to the C-terminus of V H-2 .
  • the V H-2 and the V L-2 are fused via a linker (e.g., a GS linker, e.g., (GGGGS) 4 ) .
  • the V H-1 and the V L-1 are fused without a linker.
  • the scFv is a dsscFv optionally comprising a) a G44C mutation in the V H or V H-2 according to the numbering of SEQ ID NO: 60, and b) a G100C mutation in the V L or V L-2 according to the numbering of SEQ ID NO: 61.
  • the second antibody moiety is fused to N-terminus of two heavy chains of the full-length antibody.
  • the second antibody moiety is fused to C-terminus of two heavy chains of the full-length antibody. In some embodiments, the second antibody moiety is fused to N-terminus of two light chains of the full-length antibody. In some embodiments, the second antibody moiety is fused to C-terminus of two light chains of the full-length antibody. In some embodiments, the second antibody moiety is a full-length antibody comprising two heavy chains and two light chains, and the first antibody moiety is a scFv comprising the V H-1 and the V L-1 . In some embodiments, the V H-1 is fused to the N-terminus of the V L-1 .
  • the V H-1 is fused to the C-terminus of the V L-1 optionally with a single alanine amino acid appended to the C-terminus of V H-1 .
  • the V H-1 and the V L-1 are fused via a linker (e.g., a GS linker, e.g., (GGGGS) 4 ) .
  • the scFv is a dsscFv optionally comprising a) a G44C mutation in the V H or V H-2 according to the numbering of SEQ ID NO: 60, and b) a G100C mutation in the V L or V L-2 according to the numbering of SEQ ID NO: 61.
  • the first antibody moiety is fused to N-terminus of one or two heavy chains of the full-length antibody. In some embodiments, the first antibody moiety is fused to C-terminus of one or two heavy chains of the full-length antibody. In some embodiments, the first antibody moiety is fused to N-terminus of one or two light chains of the full-length antibody. In some embodiments, the first antibody moiety is fused to C-terminus of one or two light chains of the full-length antibody. In some embodiments, the first antibody moiety and the second antibody moiety are fused via a linker (e.g., a GS linker, e.g., (GGGGS) 3 ) . In some embodiments, the first antibody moiety and the second antibody moiety are fused without a linker.
  • a linker e.g., a GS linker, e.g., (GGGGS) 3
  • a multispecific (e.g., bispecific) construct comprising a first antibody moiety that specifically recognizes Sclerostin and a second antibody moiety that specifically recognizes RANKL, wherein the multispecific construct comprises two heavy chains and two light chains, wherein the two heavy chains each comprises an amino acid sequence of SEQ ID NO: 126, wherein the two light chains each comprises an amino acid sequence of SEQ ID NO: 129.
  • a multispecific (e.g., bispecific) construct comprising a first antibody moiety that specifically recognizes Sclerostin and a second antibody moiety that specifically recognizes RANKL, wherein the multispecific construct comprises two heavy chains and two light chains, wherein the two heavy chains each comprises an amino acid sequence of SEQ ID NO: 127, wherein the two light chains each comprises an amino acid sequence of SEQ ID NO: 129.
  • a multispecific (e.g., bispecific) construct comprising a first antibody moiety that specifically recognizes Sclerostin and a second antibody moiety that specifically recognizes RANKL, wherein the multispecific construct comprises two heavy chains and two light chains, wherein the two heavy chains each comprises an amino acid sequence of SEQ ID NO: 128, wherein the two light chains each comprises an amino acid sequence of SEQ ID NO: 129.
  • a multispecific (e.g., bispecific) construct comprising a first antibody moiety that specifically recognizes Sclerostin and a second antibody moiety that specifically recognizes RANKL, wherein the multispecific construct comprises two heavy chains and two light chains, wherein the two heavy chains each comprises an amino acid sequence of SEQ ID NO: 133 wherein the two light chains each comprises an amino acid sequence of SEQ ID NO: 130.
  • a multispecific (e.g., bispecific) construct comprising a first antibody moiety that specifically recognizes Sclerostin and a second antibody moiety that specifically recognizes RANKL, wherein the multispecific construct comprises two heavy chains and two light chains, wherein the two heavy chains each comprises an amino acid sequence of SEQ ID NO: 133, wherein the two light chains each comprises an amino acid sequence of SEQ ID NO: 131.
  • a multispecific (e.g., bispecific) construct comprising a first antibody moiety that specifically recognizes Sclerostin and a second antibody moiety that specifically recognizes RANKL, wherein the multispecific construct comprises two heavy chains and two light chains, wherein the two heavy chains each comprises an amino acid sequence of SEQ ID NO: 133, wherein the two light chains each comprises an amino acid sequence of SEQ ID NO: 132.
  • a multispecific (e.g., bispecific) anti-Sclerostin construct comprising a) a first antibody moiety that specifically recognizes Sclerostin comprising a first heavy chain variable region (V H-1 ) and a first light chain variable region (V L-1 )
  • the V H-1 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 1
  • the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 5
  • the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 9
  • the V L-1 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 85, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 20
  • a second antibody moiety that specifically recognizes RANKL comprising a second heavy chain variable region (V H-2 ) and a second light chain variable
  • the V H-1 comprises an amino acid sequence of SEQ ID NO: 87 or 168, and the V L-1 comprises an amino acid sequence of SEQ ID NO: 89 or 170. In some embodiments, the V H-1 comprises an amino acid sequence of SEQ ID NO: 87, and the V L-1 comprises an amino acid sequence of SEQ ID NO: 89. In some embodiments, the V H-1 comprises an amino acid sequence of SEQ ID NO: 168, and the V L-1 comprises an amino acid sequence of SEQ ID NO: 170. In some embodiments, the V H-2 comprises an amino acid sequence of SEQ ID NO: 72, and the V L-2 comprises an amino acid sequence of SEQ ID NO: 73.
  • the first antibody moiety is a full-length antibody comprising two heavy chains and two light chains
  • the second antibody moiety is a scFv comprising the V H-2 and V L-2
  • the V H-2 is fused to the N-terminus of the V L-2
  • the V H-2 is fused to the C-terminus of the V L-2 optionally with a single alanine amino acid appended to the C-terminus of V H-2
  • the V H-2 and the V L-2 are fused via a linker (e.g., a GS linker, e.g., (GGGGS) 4 ) .
  • the V H-1 and the V L-1 are fused without a linker.
  • the scFv is converted to a dsscFv with H44-L100 disulfide bond formed by G44C mutation on VH-2 and G100C mutation on VL-2.
  • the second antibody moiety is fused to N-terminus of two heavy chains of the full-length antibody. In some embodiments, the second antibody moiety is fused to C-terminus of two heavy chains of the full-length antibody. In some embodiments, the second antibody moiety is fused to N-terminus of two light chains of the full-length antibody.
  • the second antibody moiety is fused to C-terminus of two light chains of the full-length antibody.
  • the second antibody moiety is a full-length antibody comprising two heavy chains and two light chains
  • the first antibody moiety is a scFv comprising the V H-1 and the V L-1 .
  • the V H-1 is fused to the N-terminus of the V L-1 .
  • the V H-1 is fused to the C-terminus of the V L-1 optionally with a single alanine amino acid appended to the C-terminus of V H-1 .
  • the V H-1 and the V L-1 are fused via a linker (e.g., a GS linker, e.g., (GGGGS) 4 ) .
  • the V H-1 and the V L-1 are fused via a linker without a linker.
  • the scFv is a dsscFv optionally comprising a) a G44C mutation in the V H or V H-2 according to the numbering of SEQ ID NO: 60, and b) a G100C mutation in the V L or V L-2 according to the numbering of SEQ ID NO: 61.
  • the first antibody moiety is fused to N-terminus of one or two heavy chains of the full-length antibody. In some embodiments, the first antibody moiety is fused to C-terminus of one or two heavy chains of the full-length antibody. In some embodiments, the first antibody moiety is fused to N-terminus of one or two light chains of the full-length antibody. In some embodiments, the first antibody moiety is fused to C-terminus of one or two light chains of the full-length antibody. In some embodiments, the first antibody moiety and the second antibody moiety are fused via a linker (e.g., a GS linker, e.g., (GGGGS) 3 ) . In some embodiments, the first antibody moiety and the second antibody moiety are fused without a linker.
  • a linker e.g., a GS linker, e.g., (GGGGS) 3
  • the anti-RANKL antibody moiety and the anti-Sclerostin antibody moiety are fused with each other via a linker such as any of the linkers described herein with any operable form that allows the proper function of the binding moieties.
  • the anti-Sclerostin construct is a multispecific (e.g., bispecific) anti-Sclerostin construct comprising a) an anti-Sclerostin antibody moiety according to any one of the anti-Sclerostin antibody moieties described herein; b) a second antibody moiety specifically recognizing DKK1 (an anti-DKK1 antibody moiety) .
  • DKK1 (Dickkopf-related protein 1) is a member of the dickkopf family of proteins. Members of this family are secreted proteins characterized by two cysteine-rich domains that mediate protein-protein interactions. DKK1 binds to the LRP6 co-receptor and inhibits beta-catenin-dependent Wnt signaling. This gene plays a role in embryonic development and may be important in bone formation in adults.
  • the anti-DKK1 antibody moiety (such as an scFv) used in multispecific anti-Sclerostin constructs comprises an antibody moiety comprising a heavy chain variable region (V H ) and a light chain variable region (V L ) , wherein the antibody moiety competes for a binding epitope of DKK1 with an antibody or antibody fragment comprising a second heavy variable region (V H-2 ) and a second light chain variable region (V L-2 )
  • the V H-2 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 42, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 43, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 44
  • the V L-2 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 45, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 46, and the LC-CDR3 comprising the amino
  • the anti-DKK1 antibody moiety (such as an scFv) used in multispecific anti-Sclerostin constructs comprises an antibody moiety comprising a heavy chain variable region (V H ) and a light chain variable region (V L ) , wherein the antibody moiety competes for a binding epitope of DKK1 with an antibody or antibody fragment comprising a second heavy variable region (V H-2 ) and a second light chain variable region (V L-2 )
  • the V H-2 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 48, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 49, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 50
  • the V L-2 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 51, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 52, and the LC-CDR3 comprising the amino
  • the anti-DKK1 antibody moiety (such as an scFv) used in multispecific anti-Sclerostin constructs comprises an antibody moiety comprising a heavy chain variable region (V H ) and a light chain variable region (V L ) , wherein the antibody moiety competes for a binding epitope of DKK1 with an antibody or antibody fragment comprising a second heavy variable region (V H-2 ) and a second light chain variable region (V L-2 )
  • the V H-2 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 54, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 55, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 56
  • the V L-2 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 57, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 58, and the LC-CDR3 comprising
  • the anti-DKK1 antibody moiety (such as an scFv) used in multispecific anti-Sclerostin constructs comprises an antibody moiety comprising a heavy chain variable region (V H ) and a light chain variable region (V L ) , wherein the V H comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 42, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 43, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 44, and the V L comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 45, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 46, and the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 47.
  • V H comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 42
  • the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 43
  • the V H comprises an amino acid sequence of SEQ ID NO: 60, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity; and the V L comprises an amino acid sequence of SEQ ID NO: 61, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity.
  • the anti-DKK1 antibody moiety (such as an scFv) used in multispecific anti-Sclerostin constructs comprises an antibody moiety comprising a heavy chain variable region (V H ) and a light chain variable region (V L ) , wherein the V H comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 48, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 49, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 50, and the V L comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 51, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 52, and the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 58.
  • V H comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 48
  • the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 49
  • the V H comprises an amino acid sequence of SEQ ID NO: 62, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity; and the V L comprises an amino acid sequence of SEQ ID NO: 63, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity.
  • the anti-DKK1 antibody moiety (such as an scFv) used in multispecific anti-Sclerostin constructs comprises an antibody moiety comprising a heavy chain variable region (V H ) and a light chain variable region (V L ) , wherein the V H comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 54, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 55, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 56, and the V L comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 57, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 58, and the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 59.
  • V H comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 54
  • the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 55
  • the V H comprises an amino acid sequence of SEQ ID NO: 64, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity; and the V L comprises an amino acid sequence of SEQ ID NO: 65, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity.
  • the anti-DKK1 moiety comprises a HC-CDR1, a HC-CDR2, and a HC-CDR3, respectively comprising the amino acid sequences of a CDR1, a CDR2, and a CDR3 within a V H chain region having the sequence set forth in SEQ ID NO: 60, 62, or 64; and a LC-CDR1, a LC-CDR2, and a LC-CDR3, respectively comprising the amino acid sequences of a CDR1, a CDR2, and a CDR3 within a V L chain region having the sequence set forth in SEQ ID NO: 61, 63, or 65.
  • a multispecific (e.g., bispecific) anti-Sclerostin construct comprising a) an anti-Sclerostin full-length antibody comprising two heavy chains and two light chains, wherein the two heavy chains each comprises a heavy chain variable region (V H ) and the two light chains each comprises a light chain variable region (V L ) , b) an anti-DKK1 antibody moiety (such as any of the antibody moiety described herein) fused to at least both of the heavy chains of the anti-Sclerostin full-length antibody.
  • the anti-DKK1 antibody moiety is fused to N-terminus of both heavy chains.
  • the anti-DKK1 antibody moiety is fused to C-terminus of both heavy chains.
  • a multispecific (e.g., bispecific) anti-Sclerostin construct comprising a) an anti-DKK1 antibody moiety comprising a full-length antibody comprising two heavy chains and two light chains, wherein the two heavy chains each comprises a heavy chain variable region (V H ) and the two light chains each comprises a light chain variable region (V L ) , b) an anti-Sclerostin antibody moiety (such as any of the anti-Sclerostin antibody moiety described herein) fused to at least one or both of the heavy chains of the anti-DKK1 full-length antibody.
  • the anti-Sclerostin antibody moiety is fused to N-terminus of both heavy chains.
  • the anti-Sclerostin antibody moiety is fused to C-terminus of both heavy chains.
  • a multispecific (e.g., bispecific) anti-Sclerostin construct comprising a) an anti-Sclerostin full-length antibody comprising two heavy chains and two light chains, wherein the two heavy chains each comprises a heavy chain variable region (V H ) and the two light chains each comprises a light chain variable region (V L ) , b) an anti-DKK1 antibody moiety (such as any of the antibody moiety described herein) fused to at least both of the light chains of the anti-Sclerostin full-length antibody.
  • the anti-DKK1 antibody moiety is fused to N-terminus of both light chains.
  • the anti-DKK1 antibody moiety is fused to C-terminus of both light chains.
  • a multispecific (e.g., bispecific) anti-Sclerostin construct comprising a) an anti-DKK1 antibody moiety comprising a full-length antibody comprising two heavy chains and two light chains, wherein the two heavy chains each comprises a heavy chain variable region (V H ) and the two light chains each comprises a light chain variable region (V L ) , b) an anti-Sclerostin antibody moiety (such as any of the antibody moiety described herein) fused to at least one or both of the light chains of the anti-DKK1 full-length antibody.
  • the anti-Sclerostin antibody moiety is fused to N-terminus of both light chains.
  • the anti-Sclerostin antibody moiety is fused to C-terminus of both light chains.
  • the anti-Sclerostin antibody moiety and the anti-DKK1 antibody moiety are fused with each other via a linker such as any of the linkers described herein with any operable form that allows the proper function of the binding moieties.
  • the anti-Sclerostin antibody moiety and the anti-DKK1 antibody moiety are fused without a linker.
  • a multispecific (e.g., bispecific) anti-Sclerostin construct comprising a) a first antibody moiety that specifically recognizes Sclerostin comprising a first heavy chain variable region (V H-1 ) and a first light chain variable region (V L-1 )
  • the V H-1 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 1, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 5, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 9
  • the V L-1 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 15, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 20, and b) a second antibody moiety that specifically recognizes DKK1 comprising a second heavy chain variable region (V H-2 ) and a second light chain variable region (
  • the V H-1 comprises an amino acid sequence of SEQ ID NO: 22, and the V L-1 comprises an amino acid sequence of SEQ ID NO: 23. In some embodiments, the V H-1 comprises an amino acid sequence of SEQ ID NO: 87 or 168, and the V L- 1 comprises an amino acid sequence of SEQ ID NO: 88 or 169. In some embodiments, the V H-1 comprises an amino acid sequence of SEQ ID NO: 87, and the V L-1 comprises an amino acid sequence of SEQ ID NO: 88. In some embodiments, the V H-1 comprises an amino acid sequence of SEQ ID NO: 168, and the V L-1 comprises an amino acid sequence of SEQ ID NO: 169.
  • the V H-2 comprises an amino acid sequence of SEQ ID NO: 60, 164, or 166
  • the V L-2 comprises an amino acid sequence of SEQ ID NO: 61, 165, or 167.
  • the V H-2 comprises an amino acid sequence of SEQ ID NO: 164
  • the V L-2 comprises an amino acid sequence of SEQ ID NO: 165.
  • the V H-2 comprises an amino acid sequence of SEQ ID NO: 166
  • the V L-2 comprises an amino acid sequence of SEQ ID NO: 167.
  • the V H-2 comprises an amino acid sequence of SEQ ID NO: 61
  • the V L-2 comprises an amino acid sequence of SEQ ID NO: 167.
  • the first antibody moiety is a full-length antibody comprising two heavy chains and two light chains
  • the second antibody moiety is a scFv comprising the V H-2 and V L-2
  • the V H-2 is fused to the N-terminus of the V L-2 optionally with a single alanine amino acid appended to the C-terminus of V H-2 .
  • the V H-2 is fused to the C-terminus of the V L-2 .
  • the V H-2 and the V L-2 are fused via a linker (e.g., a GS linker, e.g., (GGGGS) 4 ) .
  • a linker e.g., a GS linker, e.g., (GGGGS) 4
  • the V H-1 and the V L-1 are fused without a linker.
  • the scFv is a dsscFv optionally comprising a) a G44C mutation in the V H or V H-2 according to the numbering of SEQ ID NO: 60, and b) a G100C mutation in the V L or V L-2 according to the numbering of SEQ ID NO: 61.
  • the second antibody moiety is fused to N-terminus of two heavy chains of the full-length antibody. In some embodiments, the second antibody moiety is fused to C-terminus of two heavy chains of the full-length antibody.
  • the second antibody moiety is fused to N-terminus of two light chains of the full-length antibody. In some embodiments, the second antibody moiety is fused to C-terminus of two light chains of the full-length antibody. In some embodiments, the second antibody moiety is a full-length antibody comprising two heavy chains and two light chains, and the first antibody moiety is a scFv comprising the V H-1 and the V L-1 . In some embodiments, the V H-1 is fused to the N-terminus of the V L-1 . In some embodiments, the V H-1 is fused to the C-terminus of the V L-1 optionally with a single alanine amino acid appended to the C-terminus of V H-1 .
  • the V H-1 and the V L-1 are fused via a linker (e.g., a GS linker, e.g., (GGGGS) 4 ) .
  • the V H-1 and the V L-1 are fused without a linker.
  • the scFv is a dsscFv optionally comprising a) a G44C mutation in the V H or V H-2 according to the numbering of SEQ ID NO: 60, and b) a G100C mutation in the V L or V L-2 according to the numbering of SEQ ID NO: 61.
  • the first antibody moiety is fused to N-terminus of one or two heavy chains of the full-length antibody.
  • the first antibody moiety is fused to C-terminus of one or two heavy chains of the full-length antibody. In some embodiments, the first antibody moiety is fused to N-terminus of one or two light chains of the full-length antibody. In some embodiments, the first antibody moiety is fused to C-terminus of one or two light chains of the full-length antibody. In some embodiments, the first antibody moiety and the second antibody moiety are fused via a linker (e.g., a GS linker, e.g., (GGGGS) 3 ) . In some embodiments, the first antibody moiety and the second antibody moiety are fused without a linker.
  • a linker e.g., a GS linker, e.g., (GGGGS) 3
  • a multispecific (e.g., bispecific) construct comprising a first antibody moiety that specifically recognizes Sclerostin and a second antibody moiety that specifically recognizes DKK1, wherein the multispecific construct comprises two heavy chains and two light chains, wherein the two heavy chains each comprises an amino acid sequence of SEQ ID NO: 91, wherein the two light chains each comprises an amino acid sequence of SEQ ID NO: 93.
  • a multispecific (e.g., bispecific) construct comprising a first antibody moiety that specifically recognizes Sclerostin and a second antibody moiety that specifically recognizes DKK1, wherein the multispecific construct comprises two heavy chains and two light chains, wherein the two heavy chains each comprises an amino acid sequence of SEQ ID NO: 92, wherein the two light chains each comprises an amino acid sequence of SEQ ID NO: 93.
  • a multispecific (e.g., bispecific) construct comprising a first antibody moiety that specifically recognizes Sclerostin and a second antibody moiety that specifically recognizes DKK1, wherein the multispecific construct comprises two heavy chains and two light chains, wherein the two heavy chains each comprises an amino acid sequence of SEQ ID NO: 94, wherein the two light chains each comprises an amino acid sequence of SEQ ID NO: 96.
  • a multispecific (e.g., bispecific) construct comprising a first antibody moiety that specifically recognizes Sclerostin and a second antibody moiety that specifically recognizes DKK1, wherein the multispecific construct comprises two heavy chains and two light chains, wherein the two heavy chains each comprises an amino acid sequence of SEQ ID NO: 95, wherein the two light chains each comprises an amino acid sequence of SEQ ID NO: 96.
  • a multispecific (e.g., bispecific) construct comprising a first antibody moiety that specifically recognizes Sclerostin and a second antibody moiety that specifically recognizes DKK1, wherein the multispecific construct comprises two heavy chains and two light chains, wherein the two heavy chains each comprises an amino acid sequence of SEQ ID NO: 97, wherein the two light chains each comprises an amino acid sequence of SEQ ID NO: 99.
  • a multispecific (e.g., bispecific) construct comprising a first antibody moiety that specifically recognizes Sclerostin and a second antibody moiety that specifically recognizes DKK1, wherein the multispecific construct comprises two heavy chains and two light chains, wherein the two heavy chains each comprises an amino acid sequence of SEQ ID NO: 98, wherein the two light chains each comprises an amino acid sequence of SEQ ID NO: 99.
  • a multispecific (e.g., bispecific) construct comprising a first antibody moiety that specifically recognizes Sclerostin and a second antibody moiety that specifically recognizes DKK1, wherein the multispecific construct comprises two heavy chains and two light chains, wherein the two heavy chains each comprises an amino acid sequence of SEQ ID NO: 100, wherein the two light chains each comprises an amino acid sequence of SEQ ID NO: 102.
  • a multispecific (e.g., bispecific) construct comprising a first antibody moiety that specifically recognizes Sclerostin and a second antibody moiety that specifically recognizes DKK1, wherein the multispecific construct comprises two heavy chains and two light chains, wherein the two heavy chains each comprises an amino acid sequence of SEQ ID NO: 101, wherein the two light chains each comprises an amino acid sequence of SEQ ID NO: 102.
  • a multispecific (e.g., bispecific) construct comprising a first antibody moiety that specifically recognizes Sclerostin and a second antibody moiety that specifically recognizes DKK1, wherein the multispecific construct comprises two heavy chains and two light chains, wherein the two heavy chains each comprises an amino acid sequence of SEQ ID NO: 103, wherein the two light chains each comprises an amino acid sequence of SEQ ID NO: 104.
  • a multispecific (e.g., bispecific) construct comprising a first antibody moiety that specifically recognizes Sclerostin and a second antibody moiety that specifically recognizes DKK1, wherein the multispecific construct comprises two heavy chains and two light chains, wherein the two heavy chains each comprises an amino acid sequence of SEQ ID NO: 103, wherein the two light chains each comprises an amino acid sequence of SEQ ID NO: 105.
  • a multispecific (e.g., bispecific) construct comprising a first antibody moiety that specifically recognizes Sclerostin and a second antibody moiety that specifically recognizes DKK1, wherein the multispecific construct comprises two heavy chains and two light chains, wherein the two heavy chains each comprises an amino acid sequence of SEQ ID NO: 106, wherein the two light chains each comprises an amino acid sequence of SEQ ID NO: 107.
  • a multispecific (e.g., bispecific) construct comprising a first antibody moiety that specifically recognizes Sclerostin and a second antibody moiety that specifically recognizes DKK1, wherein the multispecific construct comprises two heavy chains and two light chains, wherein the two heavy chains each comprises an amino acid sequence of SEQ ID NO: 106, wherein the two light chains each comprises an amino acid sequence of SEQ ID NO: 108.
  • a multispecific (e.g., bispecific) construct comprising a first antibody moiety that specifically recognizes Sclerostin and a second antibody moiety that specifically recognizes DKK1, wherein the multispecific construct comprises two heavy chains and two light chains, wherein the two heavy chains each comprises an amino acid sequence of SEQ ID NO: 109, wherein the two light chains each comprises an amino acid sequence of SEQ ID NO: 110.
  • a multispecific (e.g., bispecific) construct comprising a first antibody moiety that specifically recognizes Sclerostin and a second antibody moiety that specifically recognizes DKK1, wherein the multispecific construct comprises two heavy chains and two light chains, wherein the two heavy chains each comprises an amino acid sequence of SEQ ID NO: 109, wherein the two light chains each comprises an amino acid sequence of SEQ ID NO: 111.
  • a multispecific (e.g., bispecific) construct comprising a first antibody moiety that specifically recognizes Sclerostin and a second antibody moiety that specifically recognizes DKK1, wherein the multispecific construct comprises two heavy chains and two light chains, wherein the two heavy chains each comprises an amino acid sequence of SEQ ID NO: 112, wherein the two light chains each comprises an amino acid sequence of SEQ ID NO: 113.
  • a multispecific (e.g., bispecific) construct comprising a first antibody moiety that specifically recognizes Sclerostin and a second antibody moiety that specifically recognizes DKK1, wherein the multispecific construct comprises two heavy chains and two light chains, wherein the two heavy chains each comprises an amino acid sequence of SEQ ID NO: 112, wherein the two light chains each comprises an amino acid sequence of SEQ ID NO: 114.
  • a multispecific (e.g., bispecific) construct comprising a first antibody moiety that specifically recognizes Sclerostin and a second antibody moiety that specifically recognizes DKK1, wherein the multispecific construct comprises two heavy chains and two light chains, wherein the two heavy chains each comprises an amino acid sequence of SEQ ID NO: 117, wherein the two light chains each comprises an amino acid sequence of SEQ ID NO: 119.
  • a multispecific (e.g., bispecific) construct comprising a first antibody moiety that specifically recognizes Sclerostin and a second antibody moiety that specifically recognizes DKK1, wherein the multispecific construct comprises two heavy chains and two light chains, wherein the two heavy chains each comprises an amino acid sequence of SEQ ID NO: 118, wherein the two light chains each comprises an amino acid sequence of SEQ ID NO: 119.
  • a multispecific (e.g., bispecific) construct comprising a first antibody moiety that specifically recognizes Sclerostin and a second antibody moiety that specifically recognizes DKK1, wherein the multispecific construct comprises two heavy chains and two light chains, wherein the two heavy chains each comprises an amino acid sequence of SEQ ID NO: 123, wherein the two light chains each comprises an amino acid sequence of SEQ ID NO: 125.
  • a multispecific (e.g., bispecific) construct comprising a first antibody moiety that specifically recognizes Sclerostin and a second antibody moiety that specifically recognizes DKK1, wherein the multispecific construct comprises two heavy chains and two light chains, wherein the two heavy chains each comprises an amino acid sequence of SEQ ID NO: 124, wherein the two light chains each comprises an amino acid sequence of SEQ ID NO: 125.
  • a multispecific (e.g., bispecific) anti-Sclerostin construct comprising a) a first antibody moiety that specifically recognizes Sclerostin comprising a first heavy chain variable region (V H-1 ) and a first light chain variable region (V L-1 )
  • the V H-1 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 1
  • the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 5
  • the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 9
  • the V L-1 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 85, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 20
  • a second antibody moiety that specifically recognizes DKK1 comprising a second heavy chain variable region (V H-2 ) and a second light chain variable region
  • the V H-1 comprises an amino acid sequence of SEQ ID NO: 87 or 168, and the V L-1 comprises an amino acid sequence of SEQ ID NO: 89 or 170. In some embodiments, the V H-1 comprises an amino acid sequence of SEQ ID NO: 87, and the V L-1 comprises an amino acid sequence of SEQ ID NO: 89. In some embodiments, the V H-1 comprises an amino acid sequence of SEQ ID NO: 168, and the V L-1 comprises an amino acid sequence of SEQ ID NO: 170. In some embodiments, the V H-2 comprises an amino acid sequence of SEQ ID NO: 60, 164, or 166, and the V L-2 comprises an amino acid sequence of SEQ ID NO: 61, 165, or 167.
  • the V H-2 comprises an amino acid sequence of SEQ ID NO: 164, and the V L-2 comprises an amino acid sequence of SEQ ID NO: 165. In some embodiments, the V H-2 comprises an amino acid sequence of SEQ ID NO: 166, and the V L-2 comprises an amino acid sequence of SEQ ID NO: 167. In some embodiments, the V H-2 comprises an amino acid sequence of SEQ ID NO: 61, and the V L-2 comprises an amino acid sequence of SEQ ID NO: 167. In some embodiments, the first antibody moiety is a full-length antibody comprising two heavy chains and two light chains, and the second antibody moiety is a scFv comprising the V H-2 and V L-2 .
  • the V H-2 is fused to the N-terminus of the V L-2 . In some embodiments, the V H-2 is fused to the C-terminus of the V L-2 optionally with a single alanine amino acid appended to the C-terminus of V H-2 . In some embodiments, the V H-2 and the V L-2 are fused via a linker (e.g., a GS linker, e.g., (GGGGS) 4 ) . In some embodiments, the V H-1 and the V L-1 are fused without a linker.
  • a linker e.g., a GS linker, e.g., (GGGGS) 4
  • the scFv is a dsscFv optionally comprising a) a G44C mutation in the V H or V H-2 according to the numbering of SEQ ID NO: 60, and b) a G100C mutation in the V L or V L-2 according to the numbering of SEQ ID NO: 61.
  • the second antibody moiety is fused to N-terminus of two heavy chains of the full-length antibody. In some embodiments, the second antibody moiety is fused to C-terminus of two heavy chains of the full-length antibody. In some embodiments, the second antibody moiety is fused to N-terminus of two light chains of the full-length antibody.
  • the second antibody moiety is fused to C-terminus of two light chains of the full-length antibody.
  • the second antibody moiety is a full-length antibody comprising two heavy chains and two light chains
  • the first antibody moiety is a scFv comprising the V H-1 and the V L-1 .
  • the V H-1 is fused to the N-terminus of the V L-1 .
  • the V H-1 is fused to the C-terminus of the V L-1 optionally with a single alanine amino acid appended to the C-terminus of V H-1 .
  • the V H-1 and the V L-1 are fused via a linker (e.g., a GS linker, e.g., (GGGGS) 4 ) .
  • the V H-1 and the V L-1 are fused without a linker.
  • the scFv is converted to a dsscFv with H44-L100 disulfide bond formed by G44C mutation on VH-1 and G100C mutation on VL-1.
  • the first antibody moiety is fused to N-terminus of one or two heavy chains of the full-length antibody. In some embodiments, the first antibody moiety is fused to C-terminus of one or two heavy chains of the full-length antibody.
  • the first antibody moiety is fused to N-terminus of one or two light chains of the full-length antibody. In some embodiments, the first antibody moiety is fused to C-terminus of one or two light chains of the full-length antibody. In some embodiments, the first antibody moiety and the second antibody moiety are fused via a linker (e.g., a GS linker, e.g., (GGGGS) 3 ) . In some embodiments, the first antibody moiety and the second antibody moiety are fused without a linker.
  • a linker e.g., a GS linker, e.g., (GGGGS) 3
  • a multispecific (e.g., bispecific) construct comprising a first antibody moiety that specifically recognizes Sclerostin and a second antibody moiety that specifically recognizes DKK1, wherein the multispecific construct comprises two heavy chains and two light chains, wherein the two heavy chains each comprises an amino acid sequence of SEQ ID NO: 115, wherein the two light chains each comprises an amino acid sequence of SEQ ID NO: 119.
  • a multispecific (e.g., bispecific) construct comprising a first antibody moiety that specifically recognizes Sclerostin and a second antibody moiety that specifically recognizes DKK1, wherein the multispecific construct comprises two heavy chains and two light chains, wherein the two heavy chains each comprises an amino acid sequence of SEQ ID NO: 116, wherein the two light chains each comprises an amino acid sequence of SEQ ID NO: 119.
  • a multispecific (e.g., bispecific) construct comprising a first antibody moiety that specifically recognizes Sclerostin and a second antibody moiety that specifically recognizes DKK1, wherein the multispecific construct comprises two heavy chains and two light chains, wherein the two heavy chains each comprises an amino acid sequence of SEQ ID NO: 120, wherein the two light chains each comprises an amino acid sequence of SEQ ID NO: 122.
  • a multispecific (e.g., bispecific) construct comprising a first antibody moiety that specifically recognizes Sclerostin and a second antibody moiety that specifically recognizes DKK1, wherein the multispecific construct comprises two heavy chains and two light chains, wherein the two heavy chains each comprises an amino acid sequence of SEQ ID NO: 121, wherein the two light chains each comprises an amino acid sequence of SEQ ID NO: 122.
  • a multispecific (e.g., bispecific) anti-Sclerostin construct comprising a) a first antibody moiety that specifically recognizes Sclerostin comprising a first heavy chain variable region (V H-1 ) and a first light chain variable region (V L-1 )
  • the V H-1 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 1
  • the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 5
  • the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 9
  • the V L-1 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 85, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 20
  • a second antibody moiety that specifically recognizes DKK1 comprising a second heavy chain variable region (V H-2 ) and a second light chain variable region
  • the V H-1 comprises an amino acid sequence of SEQ ID NO: 87 or 168, and the V L-1 comprises an amino acid sequence of SEQ ID NO: 89 or 170. In some embodiments, the V H-1 comprises an amino acid sequence of SEQ ID NO: 87, and the V L-1 comprises an amino acid sequence of SEQ ID NO: 89. In some embodiments, the V H-1 comprises an amino acid sequence of SEQ ID NO: 168, and the V L-1 comprises an amino acid sequence of SEQ ID NO: 170. In some embodiments, the V H-2 comprises an amino acid sequence of SEQ ID NO: 62, and the V L-2 comprises an amino acid sequence of SEQ ID NO: 63.
  • the first antibody moiety is a full-length antibody comprising two heavy chains and two light chains
  • the second antibody moiety is a scFv comprising the V H-2 and V L-2
  • the V H-2 is fused to the N-terminus of the V L-2 optionally with a single alanine amino acid appended to the C-terminus of V H-2 .
  • the V H-2 is fused to the C-terminus of the V L-2 .
  • the V H-2 and the V L-2 are fused via a linker (e.g., a GS linker, e.g., (GGGGS) 4 ) .
  • a linker e.g., a GS linker, e.g., (GGGGS) 4
  • the V H-1 and the V L-1 are fused without a linker.
  • the scFv is a dsscFv optionally comprising a) a G44C mutation in the V H or V H-2 according to the numbering of SEQ ID NO: 60, and b) a G100C mutation in the V L or V L-2 according to the numbering of SEQ ID NO: 61.
  • the second antibody moiety is fused to N-terminus of two heavy chains of the full-length antibody. In some embodiments, the second antibody moiety is fused to C-terminus of two heavy chains of the full-length antibody.
  • the second antibody moiety is fused to N-terminus of two light chains of the full-length antibody. In some embodiments, the second antibody moiety is fused to C-terminus of two light chains of the full-length antibody. In some embodiments, the second antibody moiety is a full-length antibody comprising two heavy chains and two light chains, and the first antibody moiety is a scFv comprising the V H-1 and the V L-1 . In some embodiments, the V H-1 is fused to the N-terminus of the V L-1 . In some embodiments, the V H-1 is fused to the C-terminus of the V L-1 optionally with a single alanine amino acid appended to the C-terminus of V H-1 .
  • the V H-1 and the V L-1 are fused via a linker (e.g., a GS linker, e.g., (GGGGS) 4 ) .
  • the V H-1 and the V L-1 are fused without a linker.
  • the scFv is a dsscFv optionally comprising a) a G44C mutation in the V H or V H-2 according to the numbering of SEQ ID NO: 60, and b) a G100C mutation in the V L or V L-2 according to the numbering of SEQ ID NO: 61.
  • the first antibody moiety is fused to N-terminus of one or two heavy chains of the full-length antibody.
  • the first antibody moiety is fused to C-terminus of one or two heavy chains of the full-length antibody. In some embodiments, the first antibody moiety is fused to N-terminus of one or two light chains of the full-length antibody. In some embodiments, the first antibody moiety is fused to C-terminus of one or two light chains of the full-length antibody. In some embodiments, the first antibody moiety and the second antibody moiety are fused via a linker (e.g., a GS linker, e.g., (GGGGS) 3 ) . In some embodiments, the first antibody moiety and the second antibody moiety are fused without a linker.
  • a linker e.g., a GS linker, e.g., (GGGGS) 3
  • a multispecific (e.g., bispecific) anti-Sclerostin construct comprising a) a first antibody moiety that specifically recognizes Sclerostin comprising a first heavy chain variable region (V H-1 ) and a first light chain variable region (V L-1 )
  • the V H-1 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 1
  • the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 5
  • the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 9
  • the V L-1 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 85, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 20
  • a second antibody moiety that specifically recognizes DKK1 comprising a second heavy chain variable region (V H-2 ) and a second light chain variable region
  • the V H-1 comprises an amino acid sequence of SEQ ID NO: 87 or 168, and the V L-1 comprises an amino acid sequence of SEQ ID NO: 89 or 170. In some embodiments, the V H-1 comprises an amino acid sequence of SEQ ID NO: 87, and the V L-1 comprises an amino acid sequence of SEQ ID NO: 89. In some embodiments, the V H-1 comprises an amino acid sequence of SEQ ID NO: 168, and the V L-1 comprises an amino acid sequence of SEQ ID NO: 170. In some embodiments, the V H-2 comprises an amino acid sequence of SEQ ID NO: 64, and the V L-2 comprises an amino acid sequence of SEQ ID NO: 65.
  • the first antibody moiety is a full-length antibody comprising two heavy chains and two light chains
  • the second antibody moiety is a scFv comprising the V H-2 and V L-2
  • the V H-2 is fused to the N-terminus of the V L-2
  • the V H-2 is fused to the C-terminus of the V L-2 optionally with a single alanine amino acid appended to the C-terminus of V H-2
  • the V H-2 and the V L-2 are fused via a linker (e.g., a GS linker, e.g., (GGGGS) 4 ) .
  • the V H-1 and the V L-1 are fused without a linker.
  • the scFv is a dsscFv optionally comprising a) a G44C mutation in the V H or V H-2 according to the numbering of SEQ ID NO: 60, and b) a G100C mutation in the V L or V L-2 according to the numbering of SEQ ID NO: 61.
  • the second antibody moiety is fused to N-terminus of two heavy chains of the full-length antibody. In some embodiments, the second antibody moiety is fused to C-terminus of two heavy chains of the full-length antibody.
  • the second antibody moiety is fused to N-terminus of two light chains of the full-length antibody. In some embodiments, the second antibody moiety is fused to C-terminus of two light chains of the full-length antibody. In some embodiments, the second antibody moiety is a full-length antibody comprising two heavy chains and two light chains, and the first antibody moiety is a scFv comprising the V H-1 and the V L-1 . In some embodiments, the V H-1 is fused to the N-terminus of the V L-1 . In some embodiments, the V H-1 is fused to the C-terminus of the V L-1 optionally with a single alanine amino acid appended to the C-terminus of V H-2 .
  • the first antibody moiety is fused to C-terminus of one or two heavy chains of the full-length antibody. In some embodiments, the first antibody moiety is fused to N-terminus of one or two light chains of the full-length antibody. In some embodiments, the first antibody moiety is fused to C-terminus of one or two light chains of the full-length antibody. In some embodiments, the first antibody moiety and the second antibody moiety are fused via a linker (e.g., a GS linker, e.g., (GGGGS) 3 ) . In some embodiments, the first antibody moiety and the second antibody moiety are fused without a linker.
  • a linker e.g., a GS linker, e.g., (GGGGS) 3
  • a multispecific (e.g., bispecific) anti-Sclerostin construct comprising a) a first antibody moiety that specifically recognizes Sclerostin comprising a first heavy chain variable region (V H-1 ) and a first light chain variable region (V L-1 )
  • the V H-1 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 1, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 5, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 9
  • the V L-1 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 15, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 20, and b) a second antibody moiety that specifically recognizes DKK1 comprising a second heavy chain variable region (V H-2 ) and a second light chain variable region (
  • the V H-1 comprises an amino acid sequence of SEQ ID NO: 22, and the V L-1 comprises an amino acid sequence of SEQ ID NO: 23. In some embodiments, the V H-1 comprises an amino acid sequence of SEQ ID NO: 87 or 168, and the V L- 1 comprises an amino acid sequence of SEQ ID NO: 88 or 169. In some embodiments, the V H-1 comprises an amino acid sequence of SEQ ID NO: 87, and the V L-1 comprises an amino acid sequence of SEQ ID NO: 88. In some embodiments, the V H-1 comprises an amino acid sequence of SEQ ID NO: 168, and the V L-1 comprises an amino acid sequence of SEQ ID NO: 169.
  • the V H-2 comprises an amino acid sequence of SEQ ID NO: 62
  • the V L-2 comprises an amino acid sequence of SEQ ID NO: 63.
  • the first antibody moiety is a full-length antibody comprising two heavy chains and two light chains
  • the second antibody moiety is a scFv comprising the V H-2 and V L-2 .
  • the V H-2 is fused to the N-terminus of the V L-2 .
  • the V H-2 is fused to the C-terminus of the V L-2 optionally with a single alanine amino acid appended to the C-terminus of V H-2 .
  • the V H-2 and the V L-2 are fused via a linker (e.g., a GS linker, e.g., (GGGGS) 4 ) .
  • the V H-1 and the V L-1 are fused without a linker.
  • the scFv is a dsscFv optionally comprising a) a G44C mutation in the V H or V H-2 according to the numbering of SEQ ID NO: 60, and b) a G100C mutation in the V L or V L-2 according to the numbering of SEQ ID NO: 61.
  • the second antibody moiety is fused to N-terminus of two heavy chains of the full-length antibody.
  • the second antibody moiety is fused to C-terminus of two heavy chains of the full-length antibody. In some embodiments, the second antibody moiety is fused to N-terminus of two light chains of the full-length antibody. In some embodiments, the second antibody moiety is fused to C-terminus of two light chains of the full-length antibody. In some embodiments, the second antibody moiety is a full-length antibody comprising two heavy chains and two light chains, and the first antibody moiety is a scFv comprising the V H-1 and the V L-1 . In some embodiments, the V H-1 is fused to the N-terminus of the V L-1 .
  • the V H-1 is fused to the C-terminus of the V L-1 optionally with a single alanine amino acid appended to the C-terminus of V H-1 .
  • the V H-1 and the V L-1 are fused via a linker (e.g., a GS linker, e.g., (GGGGS) 4 ) .
  • the V H-1 and the V L-1 are fused without a linker.
  • the scFv is a dsscFv optionally comprising a) a G44C mutation in the V H or V H-2 according to the numbering of SEQ ID NO: 60, and b) a G100C mutation in the V L or V L-2 according to the numbering of SEQ ID NO: 61.
  • the first antibody moiety is fused to N-terminus of one or two heavy chains of the full-length antibody. In some embodiments, the first antibody moiety is fused to C-terminus of one or two heavy chains of the full-length antibody. In some embodiments, the first antibody moiety is fused to N-terminus of one or two light chains of the full-length antibody.
  • the first antibody moiety is fused to C-terminus of one or two light chains of the full-length antibody. In some embodiments, the first antibody moiety and the second antibody moiety are fused via a linker (e.g., a GS linker, e.g., (GGGGS) 3 ) . In some embodiments, the first antibody moiety and the second antibody moiety are fused without a linker.
  • a linker e.g., a GS linker, e.g., (GGGGS) 3
  • the first antibody moiety and the second antibody moiety are fused without a linker.
  • a multispecific (e.g., bispecific) anti-Sclerostin construct comprising a) a first antibody moiety that specifically recognizes Sclerostin comprising a first heavy chain variable region (V H-1 ) and a first light chain variable region (V L-1 )
  • the V H-1 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 1, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 5, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 9
  • the V L-1 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 15, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 20, and b) a second antibody moiety that specifically recognizes DKK1 comprising a second heavy chain variable region (V H-2 ) and a second light chain variable region (
  • the V H-1 comprises an amino acid sequence of SEQ ID NO: 22, and the V L-1 comprises an amino acid sequence of SEQ ID NO: 23. In some embodiments, the V H-1 comprises an amino acid sequence of SEQ ID NO: 87 or 168, and the V L- 1 comprises an amino acid sequence of SEQ ID NO: 88 or 169. In some embodiments, the V H-1 comprises an amino acid sequence of SEQ ID NO: 87, and the V L-1 comprises an amino acid sequence of SEQ ID NO: 88. In some embodiments, the V H-1 comprises an amino acid sequence of SEQ ID NO: 168, and the V L-1 comprises an amino acid sequence of SEQ ID NO: 169.
  • the V H-2 comprises an amino acid sequence of SEQ ID NO: 64
  • the V L-2 comprises an amino acid sequence of SEQ ID NO: 65
  • the first antibody moiety is a full-length antibody comprising two heavy chains and two light chains
  • the second antibody moiety is a scFv comprising the V H-2 and V L-2
  • the V H-2 is fused to the N-terminus of the V L-2
  • the V H-2 is fused to the C-terminus of the V L-2 optionally with a single alanine amino acid appended to the C-terminus of V H-2 .
  • the V H-2 and the V L-2 are fused via a linker (e.g., a GS linker, e.g., (GGGGS) 4 ) .
  • the V H-1 and the V L-1 are fused without a linker.
  • the scFv is a dsscFv optionally comprising a) a G44C mutation in the V H or V H-2 according to the numbering of SEQ ID NO: 60, and b) a G100C mutation in the V L or V L-2 according to the numbering of SEQ ID NO: 61.
  • the second antibody moiety is fused to N-terminus of two heavy chains of the full-length antibody.
  • the second antibody moiety is fused to C-terminus of two heavy chains of the full- length antibody. In some embodiments, the second antibody moiety is fused to N-terminus of two light chains of the full-length antibody. In some embodiments, the second antibody moiety is fused to C-terminus of two light chains of the full-length antibody. In some embodiments, the second antibody moiety is a full-length antibody comprising two heavy chains and two light chains, and the first antibody moiety is a scFv comprising the V H-1 and the V L-1 . In some embodiments, the V H-1 is fused to the N-terminus of the V L-1 .
  • the V H-1 is fused to the C-terminus of the V L-1 optionally with a single alanine amino acid appended to the C-terminus of V H-1 .
  • the V H-1 and the V L-1 are fused via a linker (e.g., a GS linker, e.g., (GGGGS) 4 ) .
  • the V H-1 and the V L-1 are fused without a linker.
  • the scFv is a dsscFv optionally comprising a) a G44C mutation in the V H or V H-2 according to the numbering of SEQ ID NO: 60, and b) a G100C mutation in the V L or V L-2 according to the numbering of SEQ ID NO: 61.
  • the first antibody moiety is fused to N-terminus of one or two heavy chains of the full-length antibody. In some embodiments, the first antibody moiety is fused to C-terminus of one or two heavy chains of the full-length antibody. In some embodiments, the first antibody moiety is fused to N-terminus of one or two light chains of the full-length antibody.
  • the first antibody moiety is fused to C-terminus of one or two light chains of the full-length antibody. In some embodiments, the first antibody moiety and the second antibody moiety are fused via a linker (e.g., a GS linker, e.g., (GGGGS) 3 ) . In some embodiments, the first antibody moiety and the second antibody moiety are fused without a linker.
  • a linker e.g., a GS linker, e.g., (GGGGS) 3
  • the first antibody moiety and the second antibody moiety are fused without a linker.
  • a multispecific construct specifically recognizing Sclerostin and DKK1, comprising a first antibody moiety and a second antibody, wherein the first antibody moiety comprises a first heavy chain variable region (V H-1 ) and a first light chain variable region (V L-1 ) , and wherein the second antibody moiety comprises a second heavy chain variable region (V H-2 ) and a second light chain variable region (V L-2 ) , wherein the construct comprises: a) a first polypeptide comprising a first light chain comprising, from N-terminus to C-terminus, i) the V L-1 , ii) a first light chain constant domain ( “first CL domain” ) ; b) a second polypeptide comprising a first heavy chain, from N-terminus to C-terminus, i) the V H-1 , ii) a first heavy chain constant domain ( “first CH1 domain” ) , and iii) a first Fc domain; c)
  • one of the first and the second Fc domains comprises a T366W mutation, and optionally a S354C mutation, and wherein the other Fc domain comprises a T366S mutation, a L368A mutation, a Y407V mutation, and optionally a Y349C mutation, wherein numbering is according to the EU index.
  • either i) the first CH1 domain and the first CL domain or ii) the second CH1 domain and the second CL domain are selected from the group consisting of: a) a CH1 domain wherein the amino acid at position 141 is substituted for cysteine and the cysteine at position 131 (e.g., in IgG2 or IgG4) or 220 (e.g., in IgG1) is substituted for a non-cysteine amino acid; and a CL domain wherein the amino acid at position 116 is substituted for cysteine and the cysteine at position 214 is substituted for a non-cysteine amino acid; b) a CH1 domain wherein the amino acid at position 168 is substituted for cysteine and the cysteine at position 131 (e.g., in IgG2 or IgG4) or 220 (e.g., in IgG1) is substituted for a non-cysteine amino acid; and a CL domain wherein the amino acid at
  • the first heavy chain comprises a modified human IgG4 heavy chain Fc region comprising S228P, T366W, H435R, and Y436F;
  • the second heavy chain comprises a modified human IgG4 heavy chain Fc region comprising F126C, C131S, S228P, T366S, L368A, and Y407V;
  • the second light chain comprises a modified human Ig kappa light chain constant region comprising S121C and C214S.
  • the first heavy chain comprises a modified human IgG4 heavy chain Fc region comprising S228P, T366S, L368A, and Y407V;
  • the second heavy chain comprises a modified human IgG4 heavy chain Fc region comprising F126C, C131S, S228P, T366W, H435R, and Y436F;
  • the second light chain comprises a modified human Ig kappa light chain constant region comprising S121C and C214S.
  • the first heavy chain comprises a modified human IgG4 heavy chain Fc region comprising S228P, T366W, H435R, and Y436F;
  • the second heavy chain comprises a modified human IgG4 heavy chain Fc region comprising L128C, C131S, S228P, T366S, L368A, and Y407V;
  • the second light chain comprises a modified human Ig kappa light chain constant region comprising F118C and C214S.
  • the first heavy chain comprises a modified human IgG4 heavy chain Fc region comprising S228P, T366S, L368A, and Y407V;
  • the second heavy chain comprises a modified human IgG4 heavy chain Fc region comprising L128C, C131S, S228P, T366W, H435R, and Y436F;
  • the second light chain comprises a modified human Ig kappa light chain constant region comprising F118C and C214S.
  • the first heavy chain comprises a modified human IgG4 heavy chain Fc region comprising S228P, T366S, L368A, and Y407V;
  • the second heavy chain comprises a modified human IgG4 heavy chain Fc region comprising F170C, C131S, S228P, T366W, H435R, and Y436F;
  • the second light chain comprises a modified human Ig kappa light chain constant region comprising S176C and C214S.
  • the first heavy chain comprises a modified human IgG4 heavy chain Fc region comprising S228P, T366S, L368A, and Y407V;
  • the second heavy chain comprises a modified human IgG4 heavy chain Fc region comprising V173C, C131S, S228P, T366W, H435R, and Y436F;
  • the second light chain comprises a modified human Ig kappa light chain constant region comprising Q160C and C214S.
  • the first antibody moiety specifically recognizing Sclerostin, and the second antibody moiety specifically recognizing DKK1.
  • the V H-1 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 1, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 5, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 9, and the V L-1 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 15 or 85, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 20.
  • the V H-1 comprises an amino acid sequence of SEQ ID NO: 22, and the V L-1 comprises an amino acid sequence of SEQ ID NO: 23. In some embodiments, the V H-1 comprises an amino acid sequence of SEQ ID NO: 87 or 168, and the V L-1 comprises an amino acid sequence of SEQ ID NO: 88 or 169. In some embodiments, the V H-1 comprises an amino acid sequence of SEQ ID NO: 87, and the V L-1 comprises an amino acid sequence of SEQ ID NO: 88. In some embodiments, the V H-1 comprises an amino acid sequence of SEQ ID NO: 168, and the V L-1 comprises an amino acid sequence of SEQ ID NO: 169.
  • the V H-1 comprises an amino acid sequence of SEQ ID NO: 87 or 168, and the V L-1 comprises an amino acid sequence of SEQ ID NO: 89 or 160. In some embodiments, the V H-1 comprises an amino acid sequence of SEQ ID NO: 87, and the V L-1 comprises an amino acid sequence of SEQ ID NO: 89. In some embodiments, the V H-1 comprises an amino acid sequence of SEQ ID NO: 168, and the V L-1 comprises an amino acid sequence of SEQ ID NO: 170.
  • the V H-2 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 42, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 43, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 44
  • the V L-2 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 45, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 46, and the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 47
  • the V H-2 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 48, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 49, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 50
  • the V L-2 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 51, the LC-CDR2 comprising
  • the first antibody moiety specifically recognizing DKK1, and the second antibody moiety specifically recognizing Sclerostin.
  • the V H-2 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 1, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 5, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 9, and the V L-2 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 15 or 85, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 20.
  • the V H-2 comprises an amino acid sequence of SEQ ID NO: 22, and the V L-2 comprises an amino acid sequence of SEQ ID NO: 23. In some embodiments, the V H-2 comprises an amino acid sequence of SEQ ID NO: 87 or 168, and the V L-2 comprises an amino acid sequence of SEQ ID NO: 88 or 169. In some embodiments, the V H-2 comprises an amino acid sequence of SEQ ID NO: 87, and the V L-2 comprises an amino acid sequence of SEQ ID NO: 88. In some embodiments, the V H-2 comprises an amino acid sequence of SEQ ID NO: 168, and the V L-2 comprises an amino acid sequence of SEQ ID NO: 169.
  • the V H-2 comprises an amino acid sequence of SEQ ID NO: 87 or 169, and the V L-2 comprises an amino acid sequence of SEQ ID NO: 89 or 170. In some embodiments, the V H-2 comprises an amino acid sequence of SEQ ID NO: 87, and the V L-2 comprises an amino acid sequence of SEQ ID NO: 89. In some embodiments, the V H-2 comprises an amino acid sequence of SEQ ID NO: 168, and the V L-2 comprises an amino acid sequence of SEQ ID NO: 170.
  • the V H-1 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 42, the HC- CDR2 comprising the amino acid sequence of SEQ ID NO: 43, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 44
  • the V L-1 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 45, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 46, and the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 47
  • the V H-1 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 48, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 49, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 50
  • the V L-1 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 51, the LC-CDR2 comprising
  • a multispecific construct comprising a first antibody moiety that specifically recognizes Sclerostin and a second antibody moiety that specifically recognizes DKK1, wherein the first antibody moiety is an anti-Sclerostin full-length antibody comprising two heavy chains and two light chains, wherein the two heavy chains each comprises a first heavy chain variable region (V H-1 ) , wherein the two light chains each comprises a first light chain variable region (V L-1 ) , and wherein the second antibody moiety comprises an anti-DKK1 single chain Fv fragment (scFv) comprising a second heavy chain variable region (V H-2 ) and a second light chain variable region (V L-2 ) , wherein the second antibody moiety is fused to C-terminus of both heavy chains of the anti-Sclerostin full-length antibody.
  • the first antibody moiety is an anti-Sclerostin full-length antibody comprising two heavy chains and two light chains
  • the two heavy chains each comprises a first heavy chain variable region (V H-1 )
  • the V H-1 comprises an amino acid sequence of SEQ ID NO: 22, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity; and the V L-1 comprises an amino acid sequence of SEQ ID NO: 23, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity.
  • the V H-2 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 42, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 43, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 44
  • the V L-2 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 45, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 46, and the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 47.
  • the V H-2 comprises an amino acid sequence of SEQ ID NO: 60, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity; and the V L-1 comprises an amino acid sequence of SEQ ID NO: 61, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity.
  • a multispecific construct specifically recognizing Sclerostin and DKK1, comprising a first antibody moiety and a second antibody, wherein the first antibody moiety comprises a first heavy chain variable region (V H-1 ) and a first light chain variable region (V L-1 ) , and wherein the second antibody moiety comprises a second heavy chain variable region (V H-2 ) and a second light chain variable region (V L-2 ) , wherein the construct comprises: a) a first polypeptide comprising a first light chain comprising, from N-terminus to C-terminus, i) the V L-1 , ii) a first light chain constant domain ( “first CL domain” ) ; b) a second polypeptide comprising a first heavy chain, from N-terminus to C-terminus, i) the V H-1 , ii) a first heavy chain constant domain ( “first CH1 domain” ) , and iii) a first Fc domain; c)
  • the V H-1 comprises an amino acid sequence of SEQ ID NO: 22, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity; and the V L-1 comprises an amino acid sequence of SEQ ID NO: 23, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity.
  • the V H-2 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 42, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 43, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 44
  • the V L-2 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 45, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 46, and the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 47.
  • the V H-2 comprises an amino acid sequence of SEQ ID NO: 60, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity; and the V L-1 comprises an amino acid sequence of SEQ ID NO: 61, or a variant comprising an amino acid sequence having at least about 80% (such as at least about any one of 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99%) sequence identity.
  • a multispecific (e.g., bispecific) construct comprising a) a first heavy chain comprising a first variable heavy chain variable region (V H-1 ) and a first heavy chain constant region, wherein the first heavy chain comprises an amino acid sequence of SEQ ID NO: 134; b) a first light chain comprising a first light chain variable region (V L-1 ) and a first light chain constant region, wherein the first light chain comprises an amino acid sequence of SEQ ID NO: 135; c) a second heavy chain comprising a second variable heavy chain variable region (V H-2 ) and a second heavy chain constant region, wherein the second heavy chain comprises the amino acid sequence of SEQ ID NO: 136; and d) a second light chain comprising a second light chain variable region (V L-2 ) and a second light chain constant region, wherein the second light chain comprises the amino acid sequence of SEQ ID NO: 137, wherein the V H-1 and the V L-1 comprises a first antibody moiety specifically
  • a multispecific (e.g., bispecific) construct comprising a) a first heavy chain comprising a first variable heavy chain variable region (V H-1 ) and a first heavy chain constant region, wherein the first heavy chain comprises an amino acid sequence of SEQ ID NO: 134; b) a first light chain comprising a first light chain variable region (V L-1 ) and a first light chain constant region, wherein the first light chain comprises an amino acid sequence of SEQ ID NO: 135; c) a second heavy chain comprising a second variable heavy chain variable region (V H-2 ) and a second heavy chain constant region, wherein the second heavy chain comprises the amino acid sequence of SEQ ID NO: 138; and d) a second light chain comprising a second light chain variable region (V L-2 ) and a second light chain constant region, wherein the second light chain comprises the amino acid sequence of SEQ ID NO: 139, wherein the V H-1 and the V L-1 comprises a first antibody moiety specifically
  • a multispecific (e.g., bispecific) construct comprising a) a first heavy chain comprising a first variable heavy chain variable region (V H-1 ) and a first heavy chain constant region, wherein the first heavy chain comprises an amino acid sequence of SEQ ID NO: 134; b) a first light chain comprising a first light chain variable region (V L-1 ) and a first light chain constant region, wherein the first light chain comprises an amino acid sequence of SEQ ID NO: 135; c) a second heavy chain comprising a second variable heavy chain variable region (V H-2 ) and a second heavy chain constant region, wherein the second heavy chain comprises the amino acid sequence of SEQ ID NO: 140; and d) a second light chain comprising a second light chain variable region (V L-2 ) and a second light chain constant region, wherein the second light chain comprises the amino acid sequence of SEQ ID NO: 141, wherein the V H-1 and the V L-1 comprises a first antibody moiety specifically
  • a multispecific (e.g., bispecific) construct comprising a) a first heavy chain comprising a first variable heavy chain variable region (V H-1 ) and a first heavy chain constant region, wherein the first heavy chain comprises an amino acid sequence of SEQ ID NO: 134; b) a first light chain comprising a first light chain variable region (V L-1 ) and a first light chain constant region, wherein the first light chain comprises an amino acid sequence of SEQ ID NO: 135; c) a second heavy chain comprising a second variable heavy chain variable region (V H-2 ) and a second heavy chain constant region, wherein the second heavy chain comprises the amino acid sequence of SEQ ID NO: 142; and d) a second light chain comprising a second light chain variable region (V L-2 ) and a second light chain constant region, wherein the second light chain comprises the amino acid sequence of SEQ ID NO: 143, wherein the V H-1 and the V L-1 comprises a first antibody moiety specifically
  • a multispecific (e.g., bispecific) construct comprising a) a first heavy chain comprising a first variable heavy chain variable region (V H-1 ) and a first heavy chain constant region, wherein the first heavy chain comprises an amino acid sequence of SEQ ID NO: 134; b) a first light chain comprising a first light chain variable region (V L-1 ) and a first light chain constant region, wherein the first light chain comprises an amino acid sequence of SEQ ID NO: 135; c) a second heavy chain comprising a second variable heavy chain variable region (V H-2 ) and a second heavy chain constant region, wherein the second heavy chain comprises the amino acid sequence of SEQ ID NO: 144; and d) a second light chain comprising a second light chain variable region (V L-2 ) and a second light chain constant region, wherein the second light chain comprises the amino acid sequence of SEQ ID NO: 145, wherein the V H-1 and the V L-1 comprises a first antibody moiety specifically
  • a multispecific (e.g., bispecific) construct comprising a) a first heavy chain comprising a first variable heavy chain variable region (V H-1 ) and a first heavy chain constant region, wherein the first heavy chain comprises an amino acid sequence of SEQ ID NO: 146; b) a first light chain comprising a first light chain variable region (V L-1 ) and a first light chain constant region, wherein the first light chain comprises an amino acid sequence of SEQ ID NO: 147; c) a second heavy chain comprising a second variable heavy chain variable region (V H-2 ) and a second heavy chain constant region, wherein the second heavy chain comprises the amino acid sequence of SEQ ID NO: 148; and d) a second light chain comprising a second light chain variable region (V L-2 ) and a second light chain constant region, wherein the second light chain comprises the amino acid sequence of SEQ ID NO: 149, wherein the V H-1 and the V L-1 comprises a first antibody moiety specifically
  • a multispecific (e.g., bispecific) construct comprising a) a first heavy chain comprising a first variable heavy chain variable region (V H-1 ) and a first heavy chain constant region, wherein the first heavy chain comprises an amino acid sequence of SEQ ID NO: 146; b) a first light chain comprising a first light chain variable region (V L-1 ) and a first light chain constant region, wherein the first light chain comprises an amino acid sequence of SEQ ID NO: 147; c) a second heavy chain comprising a second variable heavy chain variable region (V H-2 ) and a second heavy chain constant region, wherein the second heavy chain comprises the amino acid sequence of SEQ ID NO: 150; and d) a second light chain comprising a second light chain variable region (V L-2 ) and a second light chain constant region, wherein the second light chain comprises the amino acid sequence of SEQ ID NO: 151, wherein the V H-1 and the V L-1 comprises a first antibody moiety specifically
  • a multispecific (e.g., bispecific) construct comprising a) a first heavy chain comprising a first variable heavy chain variable region (V H-1 ) and a first heavy chain constant region, wherein the first heavy chain comprises an amino acid sequence of SEQ ID NO: 146; b) a first light chain comprising a first light chain variable region (V L-1 ) and a first light chain constant region, wherein the first light chain comprises an amino acid sequence of SEQ ID NO: 147; c) a second heavy chain comprising a second variable heavy chain variable region (V H-2 ) and a second heavy chain constant region, wherein the second heavy chain comprises the amino acid sequence of SEQ ID NO: 152; and d) a second light chain comprising a second light chain variable region (V L-2 ) and a second light chain constant region, wherein the second light chain comprises the amino acid sequence of SEQ ID NO: 153, wherein the V H-1 and the V L-1 comprises a first antibody moiety specifically
  • a multispecific (e.g., bispecific) construct comprising a) a first heavy chain comprising a first variable heavy chain variable region (V H-1 ) and a first heavy chain constant region, wherein the first heavy chain comprises an amino acid sequence of SEQ ID NO: 146; b) a first light chain comprising a first light chain variable region (V L-1 ) and a first light chain constant region, wherein the first light chain comprises an amino acid sequence of SEQ ID NO: 147; c) a second heavy chain comprising a second variable heavy chain variable region (V H-2 ) and a second heavy chain constant region, wherein the second heavy chain comprises the amino acid sequence of SEQ ID NO: 154; and d) a second light chain comprising a second light chain variable region (V L-2 ) and a second light chain constant region, wherein the second light chain comprises the amino acid sequence of SEQ ID NO: 155, wherein the V H-1 and the V L-1 comprises a first antibody moiety specifically
  • a multispecific (e.g., bispecific) construct comprising a) a first heavy chain comprising a first variable heavy chain variable region (V H-1 ) and a first heavy chain constant region, wherein the first heavy chain comprises an amino acid sequence of SEQ ID NO: 146; b) a first light chain comprising a first light chain variable region (V L-1 ) and a first light chain constant region, wherein the first light chain comprises an amino acid sequence of SEQ ID NO: 147; c) a second heavy chain comprising a second variable heavy chain variable region (V H-2 ) and a second heavy chain constant region, wherein the second heavy chain comprises the amino acid sequence of SEQ ID NO: 156; and d) a second light chain comprising a second light chain variable region (V L-2 ) and a second light chain constant region, wherein the second light chain comprises the amino acid sequence of SEQ ID NO: 157, wherein the V H-1 and the V L-1 comprises a first antibody moiety specifically
  • a multispecific (e.g., bispecific) construct comprising a) a first heavy chain comprising a first variable heavy chain variable region (V H-1 ) and a first heavy chain constant region, wherein the first heavy chain comprises an amino acid sequence of SEQ ID NO: 146; b) a first light chain comprising a first light chain variable region (V L-1 ) and a first light chain constant region, wherein the first light chain comprises an amino acid sequence of SEQ ID NO: 147; c) a second heavy chain comprising a second variable heavy chain variable region (V H-2 ) and a second heavy chain constant region, wherein the second heavy chain comprises the amino acid sequence of SEQ ID NO: 158; and d) a second light chain comprising a second light chain variable region (V L-2 ) and a second light chain constant region, wherein the second light chain comprises the amino acid sequence of SEQ ID NO: 159, wherein the V H-1 and the V L-1 comprises a first antibody moiety specifically
  • a multispecific (e.g., bispecific) construct comprising a) a first heavy chain comprising a first variable heavy chain variable region (V H-1 ) and a first heavy chain constant region, wherein the first heavy chain comprises an amino acid sequence of SEQ ID NO: 146; b) a first light chain comprising a first light chain variable region (V L-1 ) and a first light chain constant region, wherein the first light chain comprises an amino acid sequence of SEQ ID NO: 147; c) a second heavy chain comprising a second variable heavy chain variable region (V H-2 ) and a second heavy chain constant region, wherein the second heavy chain comprises the amino acid sequence of SEQ ID NO: 160; and d) a second light chain comprising a second light chain variable region (V L-2 ) and a second light chain constant region, wherein the second light chain comprises the amino acid sequence of SEQ ID NO: 161, wherein the V H-1 and the V L-1 comprises a first antibody moiety specifically recognizing
  • a multispecific (e.g., bispecific) construct comprising a) a first heavy chain comprising a first variable heavy chain variable region (V H-1 ) and a first heavy chain constant region, wherein the first heavy chain comprises an amino acid sequence of SEQ ID NO: 146; b) a first light chain comprising a first light chain variable region (V L-1 ) and a first light chain constant region, wherein the first light chain comprises an amino acid sequence of SEQ ID NO: 147; c) a second heavy chain comprising a second variable heavy chain variable region (V H-2 ) and a second heavy chain constant region, wherein the second heavy chain comprises the amino acid sequence of SEQ ID NO: 162; and d) a second light chain comprising a second light chain variable region (V L-2 ) and a second light chain constant region, wherein the second light chain comprises the amino acid sequence of SEQ ID NO: 163, wherein the V H-1 and the V L-1 comprises a first antibody moiety specifically
  • the anti-Sclerostin constructs in some embodiments is a fusion protein or an antibody-drug conjugate that comprises an anti-Sclerostin antibody moiety (e.g., an anti-Sclerostin scFv) and a second moiety.
  • an anti-Sclerostin antibody moiety e.g., an anti-Sclerostin scFv
  • the second moiety comprises a half-life extending moiety.
  • the half-life extending moiety is an albumin binding moiety (e.g., an albumin binding antibody moiety) .
  • the second moiety comprises an agent selected from the group consisting of a parathyroid hormone (PTH) , a selective estrogen receptor modulator (SERM) , a bisphosphonate, a prostaglandin E (PGE) receptor agonist, VEGF, TGF ⁇ , growth factor (myostatin) and calcitonin.
  • PTH parathyroid hormone
  • SERM selective estrogen receptor modulator
  • PGE prostaglandin E
  • the anti-Sclerostin antibody moiety and the second moiety are fused via a linker (such as any of the linkers described in the “Linkers” section) . In some embodiments, the anti-Sclerostin antibody moiety and the second moiety are fused without a linker.
  • the anti-Sclerostin constructs described herein comprise one or more linkers between two moieties (e.g., the anti-Sclerostin antibody moiety and the half-life extending moiety, the anti-Sclerostin antibody moiety and the second binding moiety in the multispecific constructs described above) .
  • the length, the degree of flexibility and/or other properties of the linker (s) used in the anti-Sclerostin constructs may have some influence on properties, including but not limited to the affinity, specificity or avidity for one or more particular antigens or epitopes. For example, longer linkers may be selected to ensure that two adjacent domains do not sterically interfere with one another.
  • a linker (such as peptide linker) comprises flexible residues (such as glycine and serine) so that the adjacent domains are free to move relative to each other.
  • a glycine-serine doublet can be a suitable peptide linker.
  • the linker is a non-peptide linker.
  • the linker is a peptide linker.
  • the linker is a non-cleavable linker.
  • the linker is a cleavable linker.
  • linker considerations include the effect on physical or pharmacokinetic properties of the resulting compound, such as solubility, lipophilicity, hydrophilicity, hydrophobicity, stability (more or less stable as well as planned degradation) , rigidity, flexibility, immunogenicity, modulation of antibody binding, the ability to be incorporated into a micelle or liposome, and the like.
  • the peptide linker may have a naturally occurring sequence, or a non-naturally occurring sequence.
  • a sequence derived from the hinge region of heavy chain only antibodies may be used as the linker. See, for example, WO1996/34103.
  • the peptide linker can be of any suitable length. In some embodiments, the peptide linker is at least about any of 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 25, 30, 35, 40, 50, 75, 100 or more amino acids long. In some embodiments, the peptide linker is no more than about any of 100, 75, 50, 40, 35, 30, 25, 20, 19, 18, 17, 16, 15, 14, 13, 12, 11, 10, 9, 8, 7, 6, 5 or fewer amino acids long.
  • the length of the peptide linker is any of about 1 amino acid to about 10 amino acids, about 1 amino acid to about 20 amino acids, about 1 amino acid to about 30 amino acids, about 5 amino acids to about 15 amino acids, about 10 amino acids to about 25 amino acids, about 5 amino acids to about 30 amino acids, about 10 amino acids to about 30 amino acids long, about 30 amino acids to about 50 amino acids, about 50 amino acids to about 100 amino acids, or about 1 amino acid to about 100 amino acids.
  • peptide linker does not comprise any polymerization activity.
  • the characteristics of a peptide linker, which comprise the absence of the promotion of secondary structures, are known in the art and described, e.g., in Dall’Acqua et al. (Biochem. (1998) 37, 9266-9273) , Cheadle et al. (Mol Immunol (1992) 29, 21-30) and Raag and Whitlow (FASEB (1995) 9 (1) , 73-80) .
  • a particularly preferred amino acid in context of the “peptide linker” is Gly.
  • peptide linkers that also do not promote any secondary structures are preferred.
  • the linkage of the domains to each other can be provided by, e.g., genetic engineering.
  • Methods for preparing fused and operatively linked bispecific single chain constructs and expressing them in mammalian cells or bacteria are well-known in the art (e.g. WO 99/54440, Ausubel, Current Protocols in Molecular Biology, Green Publishing Associates and Wiley Interscience, N.Y. 1989 and 1994 or Sambrook et al., Molecular Cloning: A Laboratory Manual, Cold Spring Harbor Laboratory Press, Cold Spring Harbor, N.Y., 2001) .
  • the peptide linker can be a stable linker, which is not cleavable by proteases, especially by Matrix metalloproteinases (MMPs) .
  • MMPs Matrix metalloproteinases
  • the linker can also be a flexible linker.
  • exemplary flexible linkers include glycine polymers (G) n (SEQ ID NO: 78) , glycine-serine polymers (including, for example, (GS) n (SEQ ID NO: 79) , (GSGGS) n (SEQ ID NO: 80) , (GGGGS) n (SEQ ID NO: 81) , and (GGGS) n (SEQ ID NO: 82) , where n is an integer of at least one) , glycine-alanine polymers, alanine-serine polymers, and other flexible linkers known in the art.
  • Glycine and glycine-serine polymers are relatively unstructured, and therefore may be able to serve as a neutral tether between components. Glycine accesses significantly more phi-psi space than even alanine, and is much less restricted than residues with longer side chains (See Scheraga, Rev. Computational Chem. 11 173-142 (1992) ) .
  • the ordinarily skilled artisan will recognize that design of an antibody fusion protein can include linkers that are all or partially flexible, such that the linker can include a flexible linker portion as well as one or more portions that confer less flexible structure to provide a desired antibody fusion protein structure.
  • exemplary linkers also include the amino acid sequence of such as (GGGGS) n (SEQ ID NO: 81) , wherein n is an integer between 1 and 8, e.g. (GGGGS) 3 (SEQ ID NO: 76) , (GGGGS) 4 (SEQ ID NO: 77) , or (GGGGS) 6 (SEQ ID NO: 83) .
  • the peptide linker comprises the amino acid sequence of (GSTSGSGKPGSGEGS) n (SEQ ID NO: 84) , wherein n is an integer between 1 and 3.
  • Coupling of two moieties may be accomplished by any chemical reaction that will bind the two molecules so long as both components retain their respective activities, e.g., binding to Sclerostin and a second agent in an anti-Sclerostin multispecific antibody, respectively.
  • This linkage can include many chemical mechanisms, for instance covalent binding, affinity binding, intercalation, coordinate binding and complexation.
  • the binding is covalent binding.
  • Covalent binding can be achieved either by direct condensation of existing side chains or by the incorporation of external bridging molecules.
  • Many bivalent or polyvalent linking agents may be useful in coupling protein molecules in this context.
  • representative coupling agents can include organic compounds such as thioesters, carbodiimides, succinimide esters, diisocyanates, glutaraldehyde, diazobenzenes and hexamethylene diamines.
  • organic compounds such as thioesters, carbodiimides, succinimide esters, diisocyanates, glutaraldehyde, diazobenzenes and hexamethylene diamines.
  • non-peptide linkers used herein include: (i) EDC (1-ethyl-3- (3-dimethylamino-propyl) carbodiimide hydrochloride; (ii) SMPT (4-succinimidyloxycarbonyl-alpha-methyl-alpha- (2-pridyl-dithio) -toluene (Pierce Chem. Co., Cat.
  • linkers described above contain components that have different attributes, thus may lead to bispecific antibodies with differing physio-chemical properties.
  • sulfo-NHS esters of alkyl carboxylates are more stable than sulfo-NHS esters of aromatic carboxylates.
  • NHS-ester containing linkers are less soluble than sulfo-NHS esters.
  • the linker SMPT contains a sterically hindered disulfide bond, and can form antibody fusion protein with increased stability.
  • Disulfide linkages are in general, less stable than other linkages because the disulfide linkage is cleaved in vitro, resulting in less antibody fusion protein available.
  • Sulfo-NHS in particular, can enhance the stability of carbodimide couplings.
  • Carbodimide couplings (such as EDC) when used in conjunction with sulfo-NHS, forms esters that are more resistant to hydrolysis than the carbodimide coupling reaction alone.
  • an anti-Sclerostin construct or antibody moiety that specifically binds to Sclerostin and a composition such as polynucleotide, nucleic acid construct, vector, host cell, or culture medium that is produced during the preparation of the anti-Sclerostin construct or antibody moiety.
  • a composition such as polynucleotide, nucleic acid construct, vector, host cell, or culture medium that is produced during the preparation of the anti-Sclerostin construct or antibody moiety.
  • the anti-Sclerostin construct or antibody moiety or composition described herein may be prepared by a number of processes as generally described below and more specifically in the Examples.
  • antibodies including anti-Sclerostin monoclonal antibodies, anti-Sclerostin bispecific antibodies, and anti-Sclerostin antibody moieties
  • the antibodies can be prepared using any known methods in the art, including those described below and in the Examples.
  • Monoclonal antibodies are obtained from a population of substantially homogeneous antibodies, i.e., the individual antibodies comprising the population are identical except for possible naturally occurring mutations and/or post-translational modifications (e.g., isomerizations, amidations) that may be present in minor amounts.
  • the modifier “monoclonal” indicates the character of the antibody as not being a mixture of discrete antibodies.
  • the monoclonal antibodies may be made using the hybridoma method first described by Kohler et al., Nature, 256: 495 (1975) , or may be made by recombinant DNA methods (U.S. Pat. No. 4,816,567) .
  • a mouse or other appropriate host animal such as a hamster or a llama
  • lymphocytes may be immunized in vitro.
  • Lymphocytes then are fused with myeloma cells using a suitable fusing agent, such as polyethylene glycol, to form a hybridoma cell (Goding, Monoclonal Antibodies: Principles and Practice, pp. 59-103 (Academic Press, 1986) . Also See Example 1 for immunization in Camels.
  • the immunizing agent will typically include the antigenic protein or a fusion variant thereof.
  • An immunizing agent may be comprised of purified full-length or truncated Sclerostin polypeptides, or variants or fragments (i.e., peptides) thereof.
  • Such peptides may be generated by proteolytic cleavage of a larger polypeptide, by recombinant molecular methodologies, or may be chemically synthesized by methods as described herein and known in the art. Based on crystallographic structure of human Sclerostin in complex with LRP6 (Kim, J.
  • the loop tip containing the ‘IGRGKWWR’ motif (SEQ ID NO: 186) was found to be the main binding determinant for binding of Sclerostin to the first propeller of LRP6.
  • Peptides useful as immunizing agent typically may have an amino acid sequence of at least 7 consecutive amino acids from a Sclerostin amino acid sequence covering the ‘IGRGKWWR’ motif on the second loop such as those described herein, and preferably have at least 8, 9, 10, 11, 12, 14, 15, 16, 18, 19, 20, 21, 22, 23, or 24 consecutive amino acids comprising the ‘IGRGKWWR’ motif.
  • Certain other preferred peptide agents comprise at least 8 but no more than 12 or more consecutive amino acids of the Sclerostin sequence covering the ‘IGRGKWWR’ motif, and other preferred peptide agent comprises 24 consecutive amino acids of the second loop of Sclerostin polypeptide.
  • Other preferred peptide agents comprise any whole integer number of amino acids between and including 8 and 24 consecutive amino acids covering ‘IGRGKWWR’ motif in the second loop thereof, or polypeptide comprising full-length Sclerostin sequence.
  • the immunizing agent is full-length human Sclerostin, or preferably a portion of the second loop thereof, e.g., synthesized peptides within the second loop as described herein covering amino acids 110-133, or more preferably 119-130, or more preferably 116-126, or more preferably 118-125, to generated antibodies that specifically recognize the ‘IGRGKWWR’ motif of the second loop on Sclerostin.
  • PBLs peripheral blood lymphocytes
  • spleen cells or lymph node cells are used if non-human mammalian sources are desired.
  • lymphocytes are then fused with an immortalized cell line using a suitable fusing agent, such as polyethylene glycol, to form a hybridoma cell.
  • a suitable fusing agent such as polyethylene glycol
  • Immortalized cell lines are usually transformed mammalian cells, particularly myeloma cells of rodent, bovine and human origin. Usually, rat or mouse myeloma cell lines are employed.
  • the hybridoma cells thus prepared are seeded and grown in a suitable culture medium that preferably contains one or more substances that inhibit the growth or survival of the unfused, parental myeloma cells.
  • the culture medium for the hybridomas typically will include hypoxanthine, aminopterin, and thymidine (HAT medium) , which are substances that prevent the growth of HGPRT-deficient cells.
  • HGPRT hypoxanthine guanine phosphoribosyl transferase
  • Preferred immortalized myeloma cells are those that fuse efficiently, support stable high-level production of antibody by the selected antibody-producing cells, and are sensitive to a medium such as HAT medium.
  • preferred are murine myeloma lines such as those derived from MOPC-21 and MPC-11 mouse tumors available from the Salk Institute Cell Distribution Center, San Diego, Calif. USA, and SP-2 cells (and derivatives thereof, e.g., X63-Ag8-653) available from the American Type Culture Collection, Manassas, Va. USA.
  • Human myeloma and mouse-human heteromyeloma cell lines also have been described for the production of human monoclonal antibodies (Kozbor, J. Immunol., 133: 3001 (1984) ; Brön et al., Monoclonal Antibody Production Techniques and Applications, pp. 51-63 (Marcel Dekker, Inc., New York, 1987) ) .
  • Culture medium in which hybridoma cells are growing is assayed for production of monoclonal antibodies directed against the antigen.
  • the binding specificity of monoclonal antibodies produced by hybridoma cells is determined ⁇ by immunoprecipitation or by an in vitro binding assay, such as radioimmunoassay (RIA) or enzyme-linked immunosorbent assay (ELISA) .
  • RIA radioimmunoassay
  • ELISA enzyme-linked immunosorbent assay
  • the culture medium in which the hybridoma cells are cultured can be assayed for the presence of monoclonal antibodies directed against the desired antigen.
  • the binding affinity and specificity of the monoclonal antibody can be determined by immunoprecipitation or by an in vitro binding assay, such as radioimmunoassay (RIA) or enzyme-linked assay (ELISA) .
  • RIA radioimmunoassay
  • ELISA enzyme-linked assay
  • binding affinity may be determined by the Scatchard analysis of Munson et al., Anal. Biochem., 107: 220 (1980) .
  • the resulting hybridomas can be screened in order to determine the presence of antibodies which are reactive with both full-length human Sclerostin and peptides from the second loop containing the ‘IGRGKWWR’ motif using ELISA or BLI approach.
  • Hybridomas that produce monoclonal antibodies that specifically bind to both full-length Sclerostin and the peptides containing the ‘IGRGKWWR’ motif thereof are preferred as described in Example 3 and 4.
  • monoclonal antibodies that were able to block, impair, or inhibit the binding of full-length human Sclerostin to a low-density lipoprotein receptor-related protein family member, e.g., LRP5 or LRP6, are selected using HEK293/TCF/LEF/Wnt1 reporter gene assay (Hannoush RN., 2008, PLoS ONE, 3: e3498) as described in Example 7.
  • the clones may be subcloned by limiting dilution procedures and grown by standard methods (Goding, supra) .
  • Suitable culture media for this purpose include, for example, D-MEM or RPMI-1640 medium.
  • the hybridoma cells may be grown in vivo as tumors in a mammal.
  • the monoclonal antibodies secreted by the subclones are suitably separated from the culture medium, ascites fluid, or serum by conventional immunoglobulin purification procedures such as, for example, protein A-Sepharose, hydroxylapatite chromatography, gel electrophoresis, dialysis, or affinity chromatography.
  • Monoclonal antibodies may also be made by recombinant DNA methods, such as those described in U.S. Pat. No. 4,816,567, and as described above.
  • DNA encoding the monoclonal antibodies is readily isolated and sequenced using conventional procedures (e.g., by using oligonucleotide probes that are capable of binding specifically to genes encoding the heavy and light chains of murine antibodies) .
  • the hybridoma cells serve as a preferred source of such DNA.
  • the DNA may be placed into expression vectors, which are then transfected into host cells such as E.
  • antibodies can be isolated from antibody phage libraries generated using the techniques described in McCafferty et al., Nature, 348: 552-554 (1990) . Clackson et al., Nature, 352: 624-628 (1991) and Marks et al., J. Mol. Biol., 222: 581-597 (1991) describe the isolation of murine and human antibodies, respectively, using phage libraries.
  • the DNA also may be modified, for example, by substituting the coding sequence for human heavy-and light-chain constant domains in place of the homologous murine sequences (U.S. Pat. No. 4,816,567; Morrison, et al., Proc. Natl Acad. Sci. USA, 81: 6851 (1984) ) , or by covalently joining to the immunoglobulin coding sequence all or part of the coding sequence for a non-immunoglobulin polypeptide.
  • non-immunoglobulin polypeptides are substituted for the constant domains of an antibody, or they are substituted for the variable domains of one antigen-combining site of an antibody to create a chimeric bivalent antibody comprising one antigen-combining site having specificity for an antigen and another antigen-combining site having specificity for a different antigen.
  • the monoclonal antibodies described herein may by monovalent, the preparation of which is well known in the art.
  • one method involves recombinant expression of immunoglobulin light chain and a modified heavy chain.
  • the heavy chain is truncated generally at any point in the Fc region so as to prevent heavy chain crosslinking.
  • the relevant cysteine residues may be substituted with another amino acid residue or are deleted so as to prevent crosslinking.
  • In vitro methods are also suitable for preparing monovalent antibodies. Digestion of antibodies to produce fragments thereof, particularly Fab fragments, can be accomplished using routine techniques known in the art.
  • Chimeric or hybrid antibodies also may be prepared in vitro using known methods in synthetic protein chemistry, including those involving crosslinking agents.
  • immunotoxins may be constructed using a disulfide-exchange reaction or by forming a thioether bond.
  • suitable reagents for this purpose include iminothiolate and methyl-4-mercaptobutyrimidate.
  • a nucleic acid molecule comprises a polynucleotide that encodes a heavy chain or a light chain of an antibody moiety (e.g., anti-Sclerostin antibody moiety) .
  • a nucleic acid molecule comprises both a polynucleotide that encodes a heavy chain and a polynucleotide that encodes a light chain, of an antibody moiety (e.g., anti-Sclerostin antibody moiety) .
  • a first nucleic acid molecule comprises a first polynucleotide that encodes a heavy chain and a second nucleic acid molecule comprises a second polynucleotide that encodes a light chain.
  • the heavy chain and the light chain are expressed from one nucleic acid molecule, or from two separate nucleic acid molecules, as two separate polypeptides.
  • a single polynucleotide encodes a single polypeptide comprising both a heavy chain and a light chain linked together.
  • a polynucleotide encoding a heavy chain or light chain of an antibody moiety comprises a nucleotide sequence that encodes a leader sequence, which, when translated, is located at the N terminus of the heavy chain or light chain.
  • the leader sequence may be the native heavy or light chain leader sequence, or may be another heterologous leader sequence.
  • the polynucleotide is a DNA. In some embodiments, the polynucleotide is an RNA. In some embodiments, the RNA is an mRNA.
  • Nucleic acid molecules may be constructed using recombinant DNA techniques conventional in the art.
  • a nucleic acid molecule is an expression vector that is suitable for expression in a selected host cell.
  • nucleic acid construct comprising any one of the polynucleotides described herein. In some embodiments, there is provided a nucleic acid construct prepared using any method described herein.
  • the nucleic acid construct further comprises a promoter operably linked to the polynucleotide.
  • the polynucleotide corresponds to a gene, wherein the promoter is a wild-type promoter for the gene.
  • a vector comprising any polynucleotides that encode the heavy chains and/or light chains of any one of the antibody moieties described herein (e.g., anti-Sclerostin antibody moieties) or nucleic acid construct described herein.
  • a vector prepared using any method described herein.
  • Vectors comprising polynucleotides that encode any of anti-Sclerostin constructs such as antibodies, scFvs, fusion proteins or other forms of constructs described herein (e.g., anti-Sclerostin scFv) are also provided.
  • a vector comprises a first polynucleotide sequence encoding a heavy chain and a second polynucleotide sequence encoding a light chain.
  • the heavy chain and light chain are expressed from the vector as two separate polypeptides.
  • the heavy chain and light chain are expressed as part of a single polypeptide, such as, for example, when the antibody is a scFv.
  • a first vector comprises a polynucleotide that encodes a heavy chain and a second vector comprises a polynucleotide that encodes a light chain.
  • the first vector and second vector are transfected into host cells in similar amounts (such as similar molar amounts or similar mass amounts) .
  • a mole-or mass-ratio of between 5: 1 and 1: 5 of the first vector and the second vector is transfected into host cells.
  • a mass ratio of between 1: 1 and 1: 5 for the vector encoding the heavy chain and the vector encoding the light chain is used.
  • a mass ratio of 1: 2 for the vector encoding the heavy chain and the vector encoding the light chain is used.
  • a vector is selected that is optimized for expression of polypeptides in CHO or CHO-derived cells, or in NS0 cells. Exemplary such vectors are described, e.g., in Running Deer et al., Biotechnol. Prog. 20: 880-889 (2004) .
  • a host cell comprising any polypeptide, nucleic acid construct and/or vector described herein. In some embodiments, there is provided a host cell prepared using any method described herein. In some embodiments, the host cell is capable of producing any of antibody moieties described herein under a fermentation condition.
  • the antibody moieties described herein may be expressed in prokaryotic cells, such as bacterial cells; or in eukaryotic cells, such as fungal cells (such as yeast) , plant cells, insect cells, and mammalian cells. Such expression may be carried out, for example, according to procedures known in the art.
  • exemplary eukaryotic cells that may be used to express polypeptides include, but are not limited to, COS cells, including COS 7 cells; 293 cells, including 293-6E cells; CHO cells, including CHO-S, DG44. Lec13 CHO cells, and FUT8 CHO cells; cells (Crucell) ; and NS0 cells.
  • the antibody moieties described herein may be expressed in yeast. See, e.g., U.S. Publication No. US 2006/0270045 A1.
  • a particular eukaryotic host cell is selected based on its ability to make desired post-translational modifications to the heavy chains and/or light chains of the antibody moiety.
  • CHO cells produce polypeptides that have a higher level of sialylation than the same polypeptide produced in 293 cells.
  • nucleic acids may be transiently or stably transfected in the desired host cells, according to any suitable method.
  • the present application also provides host cells comprising any of the polynucleotides or vectors described herein.
  • the invention provides a host cell comprising an anti-Sclerostin antibody.
  • Any host cells capable of over-expressing heterologous DNAs can be used for the purpose of isolating the genes encoding the antibody, polypeptide or protein of interest.
  • Non-limiting examples of mammalian host cells include but not limited to COS, HeLa, and CHO cells. See also PCT Publication No. WO 87/04462.
  • Suitable non-mammalian host cells include prokaryotes (such as E. coli or B. subtillis) and yeast (such as S. cerevisae, S. pombe; or K. lactis) .
  • the antibody moiety is produced in a cell-free system.
  • a cell-free system Non-limiting exemplary cell-free systems are described, e.g., in Sitaraman et al., Methods Mol. Biol. 498: 229-44 (2009) ; Spirin, Trends Biotechnol. 22: 538-45 (2004) ; Endo et al., Biotechnol. Adv. 21: 695-713 (2003) .
  • a culture medium comprising any antibody moiety, polynucleotide, nucleic acid construct, vector, and/or host cell described herein. In some embodiments, there is provided a culture medium prepared using any method described herein.
  • the medium comprises hypoxanthine, aminopterin, and/or thymidine (e.g., HAT medium) .
  • the medium does not comprise serum.
  • the medium comprises serum.
  • the medium is a D-MEM or RPMI-1640 medium.
  • the anti-Sclerostin constructs may be purified by any suitable method. Such methods include, but are not limited to, the use of affinity matrices or hydrophobic interaction chromatography. Suitable affinity ligands include the ROR1 ECD and ligands that bind antibody constant regions. For example, a Protein A, Protein G, Protein A/G, or an antibody affinity column may be used to bind the constant region and to purify an anti-Sclerostin construct comprising an Fc fragment. Hydrophobic interactive chromatography, for example, a butyl or phenyl column, may also suitable for purifying some polypeptides such as antibodies.
  • affinity ligands include the ROR1 ECD and ligands that bind antibody constant regions.
  • a Protein A, Protein G, Protein A/G, or an antibody affinity column may be used to bind the constant region and to purify an anti-Sclerostin construct comprising an Fc fragment.
  • Hydrophobic interactive chromatography for example, a butyl or
  • Ion exchange chromatography e.g. anion exchange chromatography and/or cation exchange chromatography
  • Mixed-mode chromatography e.g. reversed phase/anion exchange, reversed phase/cation exchange, hydrophilic interaction/anion exchange, hydrophilic interaction/cation exchange, etc.
  • Many methods of purifying polypeptides are known in the art.
  • a method of treating a disease or condition in an individual comprising administering to the individual an effective mount of the anti-Sclerostin construct or pharmaceutical composition described herein.
  • the disease or condition is a bone-related disorder or cartilage related disorder, a bone marrow or haemotological disorder, a musculoskeletal rare disease, a muscle-related disorder, or a cancer.
  • the bone-related disorder is osteogenesis imperfecta, osteoporosis or osteopenia (in men and/or women) , osteonecrosis, delay bone healing, non-union bone fractures, multiple myeloma, multiple myeloma related bone disorders, primary bone tumor, bone metastasis of malignancies, inflammatory or infectious bone disease, osteomalacia, hypercalcemia, Paget’s disease, immobilization-induced bone loss, glucocorticoid-induced bone loss, inflammation-induced bone loss including arthritis-induced bone loss, spaceflight osteoporosis/osteopenia and bone loss caused by reduced gravity or other disease or condition associated with a) bone loss of either quantity or quality or both and/or b) abnormality of bone structure and quality.
  • the bone-related disorder is osteoporosis or osteopenia. In some embodiments, the bone-related disorder is osteogenesis imperfecta. In some embodiments, the bone-related disorder is multiple myeloma and multiple myeloma related bone disorders.
  • the disease or condition is a cartilage disorder.
  • the cartilage disorder is chondromatosis, chondrodysplasia, achondroplasia, epiphyseal dysplasia, chondrodystrophic myotonia, juxtacortical chondroma, tear of cartilage of knee, osteofibrous dysplasia, osteoarthritis, osteogenesis imperfecta, hypophosphatemic rickets or osteochondrodystrophy.
  • the disease or condition is a muscle-related disorder.
  • the muscle-related disorder is sarcopenia and cancer sarcopenia.
  • the disease or condition is a cancer (e.g., a hematological malignancy, e.g., multiple myeloma) .
  • a cancer e.g., a hematological malignancy, e.g., multiple myeloma
  • a method of facilitation of heal after bone or joint surgeries in an individual comprising administering to the individual an effective mount of the anti-Sclerostin construct (such as any of the anti-Sclerostin constructs described herein) .
  • a method of treating a disease or condition comprising administering to the individual an effective mount of an anti-Sclerostin construct comprising an antibody moiety comprising a heavy chain variable region (V H ) and a light chain variable region (V L )
  • V H comprises i) the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 1, ii) the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 5, and iii) the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 9, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the HC-CDRs
  • the V L comprises i) the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 15 or 85, ii) the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and iii
  • a method of treating a disease or condition comprising administering to the individual an effective mount of an multispecific construct comprising a first antibody moiety that specifically recognizes Sclerostin and a second antibody moiety specifically recognizes RANKL.
  • the first antibody moiety comprises a first heavy chain variable region (V H-1 ) and a first light chain variable region (V L-1 )
  • V H-1 comprises i) the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 1, ii) the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 5, and iii) the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 9, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the HC-CDRs
  • the V L-1 comprises i) the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 15 or 85, ii) the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and iii) the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 20, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the LC-C
  • the second antibody moiety comprising a second heavy chain variable region (V H-2 ) and a second light chain variable region (V L-2 )
  • V H-2 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 66
  • the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 67
  • the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 68
  • the V L-2 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 69
  • the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 70
  • the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 71.
  • a method of treating a disease or condition comprising administering to the individual an effective mount of an multispecific construct comprising a first antibody moiety that specifically recognizes Sclerostin and a second antibody moiety specifically recognizes DKK1.
  • the first antibody moiety comprises a first heavy chain variable region (V H-1 ) and a first light chain variable region (V L-1 )
  • V H-1 comprises i) the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 1, ii) the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 5, and iii) the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 9, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the HC-CDRs
  • the V L-1 comprises i) the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 15 or 85, ii) the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and iii) the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 20, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the LC-C
  • the second antibody moiety comprising a second heavy chain variable region (V H-2 ) and a second light chain variable region (V L-2 )
  • V H-2 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 42, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 43, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 44
  • the V L-2 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 45, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 46, and the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 47
  • the V H-2 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 48, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 49, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO
  • the subject is a mammal (such as a human) .
  • the dosing regimen of the anti-Sclerostin construct (such as the specific dosages and frequencies) used for treating a disease or disorder as described herein administered into the individual may vary with the particular anti-Sclerostin construct (such as anti-Sclerostin monoclonal or multispecific antibodies, such as anti-Sclerostin fusion proteins) , the mode of administration, and the type of disease or condition being treated.
  • the effective amount of an anti-Sclerostin construct (such as anti-Sclerostin monoclonal or multispecific antibodies) is in the range of about 0.001 ⁇ g/kg to about 500 mg/kg of total body weight, for example, about 0.005 ⁇ g/kg to about 100 mg/kg, about 0.01 ⁇ g/kg to about 50 mg/kg, or about 0.01 ⁇ g/kg to about 5 mg/kg.
  • the treatment comprises more than one administration of the anti-Sclerostin constructs (such as about two, three, four, five, six, seven, eight, night, or ten administrations of anti-Sclerostin constructs) .
  • the anti-Sclerostin construct is administered at a frequency of about daily, weekly, two times per week, once a month, once every three months, once every six months, or once a year.
  • the anti-Sclerostin construct can be administered to an individual (such as human) via various routes, including, for example, intravenous, intra-articular, intra-arterial, intraperitoneal, intrapulmonary, oral, inhalation, intravesicular, intramuscular, intra-tracheal, subcutaneous, intraocular, intrathecal, transmucosal, and transdermal.
  • the anti-Sclerostin construct is included in a pharmaceutical composition while administered into the individual.
  • sustained continuous release formulation of the composition may be used.
  • the composition is administered intravenously.
  • the composition is administered intraperitoneally.
  • the composition is administered intravenously.
  • the composition is administered intraperitoneally. In some embodiments, the composition is administered intramuscularly. In some embodiments, the composition is administered subcutaneously. In some embodiments, the composition is administered intravenously. In some embodiments, the composition is administered orally.
  • This application also provides methods of administering an anti-Sclerostin construct into an individual for treating a disease or condition (such as a bone-related disease) , wherein the method further comprises administering a second agent or therapy.
  • a disease or condition such as a bone-related disease
  • the method further comprises administering a second agent or therapy.
  • the second agent or therapy is a standard or commonly used agent or therapy for treating the disease or condition.
  • a method of treating a disease or condition comprising administering to the individual a) an effective mount of an anti-Sclerostin construct (such as any of the anti-Sclerostin constructs described herein) ; and b) a second therapy or agent.
  • the second therapy or agent is an anti-DKK1 antibody or an anti-RANKL antibody.
  • the second agent or therapy comprises an agent selected from the group consisting of a parathyroid hormone (PTH) , a selective estrogen receptor modulator (SERM) , a bisphosphonate, a prostaglandin E (PGE) receptor agonist, VEGF, and TGF ⁇ , growth factor (myostatin) and calcitonin.
  • PTH parathyroid hormone
  • SERM selective estrogen receptor modulator
  • PGE prostaglandin E
  • VEGF vascular endothelial growth factor
  • TGF ⁇ growth factor (myostatin) and calcitonin.
  • a method of treating a disease or condition comprising administering to the individual a) an effective mount of an anti-Sclerostin construct (such as any of the anti-Sclerostin constructs described herein) ; and b) an anti-DKK1 antibody.
  • a disease or condition e.g., a bone-related disease
  • an anti-Sclerostin construct such as any of the anti-Sclerostin constructs described herein
  • the anti-Sclerostin construct comprises an antibody moiety comprising a heavy chain variable region (V H ) and a light chain variable region (V L )
  • V H comprises i) the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 1, ii) the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 5, and iii) the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 9, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the HC-CDRs
  • the V L comprises i) the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 15 or 85, ii) the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and iii) the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 20, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the
  • the anti-DKK1 antibody comprises a second heavy chain variable region (V H-2 ) and a second light chain variable region (V L-2 )
  • V H-2 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 66
  • the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 67
  • the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 68
  • the V L-2 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 69
  • the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 70
  • the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 71.
  • a method of treating a disease or condition comprising administering to the individual a) an effective mount of an anti-Sclerostin construct (such as any of the anti-Sclerostin constructs described herein) ; and b) an anti-RANKL antibody.
  • an anti-Sclerostin construct such as any of the anti-Sclerostin constructs described herein
  • an anti-RANKL antibody an anti-RANKL antibody
  • the anti-Sclerostin construct comprises an antibody moiety comprising a heavy chain variable region (V H ) and a light chain variable region (V L )
  • V H comprises i) the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 1, ii) the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 5, and iii) the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 9, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the HC-CDRs
  • the V L comprises i) the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 15 or 85, ii) the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and iii) the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 20, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the
  • the anti-RANKL antibody comprises a second heavy chain variable region (V H-2 ) and a second light chain variable region (V L-2 ) , wherein: a) the V H-2 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 42, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 43, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 44, and the V L-2 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 45, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 46, and the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 47; b) the V H-2 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 48, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 49, and the HC-CDR3 comprising the amino acid sequence of SEQ ID
  • the anti-Sclerostin construct and the second agent or therapy are administered simultaneously. In some embodiments, the anti-Sclerostin construct and the second agent or therapy are administered concurrently. In some embodiments, the anti-Sclerostin construct and the second agent or therapy are administered sequentially.
  • compositions comprising any one of the anti-Sclerostin construct or anti-Sclerostin antibody moiety described herein, nucleic acid encoding the antibody moieties, vector comprising the nucleic acid encoding the antibody moieties, or host cells comprising the nucleic acid or vector.
  • a pharmaceutical composition comprising an anti-Sclerostin construct (such as any of the anti-Sclerostin constructs described herein) and a pharmaceutically acceptable carrier.
  • the composition further comprises an agent selected from the group consisting of a parathyroid hormone (PTH) , a selective estrogen receptor modulator (SERM) , VEGF, TGF ⁇ , growth factor (myostatin) and calcitonin.
  • PTH parathyroid hormone
  • SERM selective estrogen receptor modulator
  • VEGF vascular endothelial growth factor
  • TGF ⁇ growth factor
  • myostatin growth factor
  • Suitable formulations of the anti-Sclerostin construct described herein can be obtained by mixing the anti-Sclerostin construct or anti-Sclerostin antibody moiety having the desired degree of purity with optional pharmaceutically acceptable carriers, excipients or stabilizers (Remington's Pharmaceutical Sciences 16th edition, Osol, A. Ed. (1980) ) , in the form of lyophilized formulations or aqueous solutions.
  • Acceptable carriers, excipients, or stabilizers are nontoxic to recipients at the dosages and concentrations employed, and include buffers such as phosphate, citrate, and other organic acids; antioxidants including ascorbic acid and methionine; preservatives (such as octadecyldimethylbenzyl ammonium chloride; hexamethonium chloride; benzalkonium chloride, benzethonium chloride; phenol, butyl or benzyl alcohol; alkyl parabens such as methyl or propylparaben; catechol; resorcinol; cyclohexanol; 3-pentanol; and m-cresol) ; low molecular weight (less than about 10 residues) polypeptides; proteins, such as serum albumin, gelatin, or immunoglobulins; hydrophilic polymers such as olyvinylpyrrolidone; amino acids such as glycine, glutamine, asparagine, his
  • Lyophilized formulations adapted for subcutaneous administration are described in WO97/04801. Such lyophilized formulations may be reconstituted with a suitable diluent to a high protein concentration and the reconstituted formulation may be administered subcutaneously to the individual to be imaged, diagnosed, or treated herein.
  • the formulations to be used for in vivo administration must be sterile. This is readily accomplished by, e.g., filtration through sterile filtration membranes.
  • kits comprising any one of the anti-Sclerostin construct or anti-Sclerostin antibody moiety described herein.
  • the kits may be useful for any of the methods of modulating cell composition or treatment described herein.
  • kits comprising an anti-Sclerostin construct specifically binding to Sclerostin.
  • the kit further comprises a device capable of delivering the anti-Sclerostin construct into an individual.
  • a device capable of delivering the anti-Sclerostin construct into an individual.
  • One type of device for applications such as parenteral delivery, is a syringe that is used to inject the composition into the body of a subject. Inhalation devices may also be used for certain applications.
  • the kit further comprises a therapeutic agent for treating a disease or condition, e.g., a bone-related disease, e.g., osteogenesis imperfecta, osteopetrosis, or a disease or condition associated with bone loss.
  • a disease or condition e.g., a bone-related disease, e.g., osteogenesis imperfecta, osteopetrosis, or a disease or condition associated with bone loss.
  • kits of the present application are in suitable packaging.
  • suitable packaging includes, but is not limited to, vials, bottles, jars, flexible packaging (e.g., sealed Mylar or plastic bags) , and the like. Kits may optionally provide additional components such as buffers and interpretative information.
  • the present application thus also provides articles of manufacture.
  • the article of manufacture can comprise a container and a label or package insert on or associated with the container.
  • Suitable containers include vials (such as sealed vials) , bottles, jars, flexible packaging, and the like.
  • the container holds a composition, and may have a sterile access port (for example the container may be an intravenous solution bag or a vial having a stopper pierceable by a hypodermic injection needle) .
  • the label or package insert indicates that the composition is used for imaging, diagnosing, or treating a particular condition in an individual.
  • the label or package insert will further comprise instructions for administering the composition to the individual and for imaging the individual.
  • the label may indicate directions for reconstitution and/or use.
  • the container holding the composition may be a multi-use vial, which allows for repeat administrations (e.g. from 2-6 administrations) of the reconstituted formulation.
  • Package insert refers to instructions customarily included in commercial packages of diagnostic products that contain information about the indications, usage, dosage, administration, contraindications and/or warnings concerning the use of such diagnostic products.
  • the article of manufacture may further comprise a second container comprising a pharmaceutically-acceptable buffer, such as bacteriostatic water for injection (BWFI) , phosphate-buffered saline, Ringer's solution and dextrose solution. It may further include other materials desirable from a commercial and user standpoint, including other buffers, diluents, filters, needles, and syringes.
  • BWFI bacteriostatic water for injection
  • kits or article of manufacture may include multiple unit doses of the compositions and instructions for use, packaged in quantities sufficient for storage and use in pharmacies, for example, hospital pharmacies and compounding pharmacies.
  • Embodiment 1 An anti-Sclerostin construct comprising an antibody moiety that specifically recognizes Sclerostin, wherein the antibody moiety binds to an epitope on Sclerostin, wherein the epitope comprises the amino acid sequence set forth in SEQ ID NO: 186.
  • Embodiment 2 An anti-Sclerostin construct comprising an antibody moiety that specifically recognizes Sclerostin, wherein the antibody moiety comprises a heavy chain variable region (V H ) and a light chain variable region (V L ) , wherein:
  • the V H comprises a HC-CDR1 comprising the amino acid sequence of any one of SEQ ID NOs: 1-4 and 12, a HC-CDR2 comprising the amino acid sequence of any one of SEQ ID NOs: 5-8 and 13, and a HC-CDR3 comprising the amino acid sequence of any one of SEQ ID NOs: 9-11 and 14, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the HC-CDRs; and
  • the V L comprises a LC-CDR1 comprising the amino acid sequence of any one of SEQ ID NOs: 15-17, 85, and 86, a LC-CDR2 comprising the amino acid sequence of any one of SEQ ID NOs: 18 and 19, and a LC-CDR3 comprising the amino acid sequence of any one of SEQ ID NOs: 20 and 21, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the LC-CDRs.
  • Embodiment 3 The anti-Sclerostin construct of embodiment 1 or embodiment 2, wherein:
  • the V H comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 12, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 13, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 14; and the V L comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 15 or 16, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and the LC-CDR3 comprising the amino acid sequence of any one of SEQ ID NOs: 20, or
  • the V H comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 1, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 5, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 9; and the V L comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 15, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and the LC-CDR3 comprising the amino acid sequence of any one of SEQ ID NOs: 20.
  • Embodiment 4 The anti-Sclerostin construct of embodiment 1 or embodiment 2, wherein the V H comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 1, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 6, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 10; and the V L comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 15, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and the LC-CDR3 comprising the amino acid sequence of any one of SEQ ID NOs: 20.
  • Embodiment 5 The anti-Sclerostin construct of embodiment 1 or embodiment 2, wherein the V H comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 2, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 7, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 10; and the V L comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 15, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and the LC-CDR3 comprising the amino acid sequence of any one of SEQ ID NOs: 20.
  • Embodiment 6 The anti-Sclerostin construct of embodiment 1 or embodiment 2, wherein the V H comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 2, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 6, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 10; and the V L comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 15, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and the LC-CDR3 comprising the amino acid sequence of any one of SEQ ID NOs: 20.
  • Embodiment 7 The anti-Sclerostin construct of embodiment 1 or embodiment 2, wherein the V H comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 1, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 5, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 10; and the V L comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 16, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and the LC-CDR3 comprising the amino acid sequence of any one of SEQ ID NOs: 20.
  • Embodiment 8 The anti-Sclerostin construct of embodiment 1 or embodiment 2, wherein the V H comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 3, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 7, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 10; and the V L comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 15, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and the LC-CDR3 comprising the amino acid sequence of any one of SEQ ID NOs: 20.
  • Embodiment 9 The anti-Sclerostin construct of embodiment 1 or embodiment 2, wherein the V H comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 1, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 5, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 10; and the V L comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 16, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and the LC-CDR3 comprising the amino acid sequence of any one of SEQ ID NOs: 20.
  • Embodiment 10 The anti-Sclerostin construct of embodiment 1 or embodiment 2, wherein the V H comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 4, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 8, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 11; and the V L comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 17, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 19, and the LC-CDR3 comprising the amino acid sequence of any one of SEQ ID NOs: 21.
  • Embodiment 11 The anti-Sclerostin construct of embodiment 1 or embodiment 2, wherein the V H comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 1, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 5, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 9; and the V L comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 85, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and the LC-CDR3 comprising the amino acid sequence of any one of SEQ ID NOs: 20.
  • Embodiment 12 The anti-Sclerostin construct of embodiment 1 or embodiment 2, wherein the V H comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 1, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 5, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 9; and the V L comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 86, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and the LC-CDR3 comprising the amino acid sequence of any one of SEQ ID NOs: 20.
  • Embodiment 13 An anti-Sclerostin construct comprising an antibody moiety that specifically recognizes Sclerostin, wherein the antibody moiety comprises a heavy chain variable region (V H ) and a light chain variable region (V L ) , wherein:
  • Embodiment 14 The anti-Sclerostin construct of any one of embodiments 1-13, wherein the V H comprises an amino acid sequence of any one of SEQ ID NOs: 22, 24, 26, 28, 30, 32, 34, 36, 38, 40, and 87, or a variant comprising an amino acid sequence having at least about 80%sequence identity; and/or wherein the V L comprises an amino acid sequence of any one of SEQ ID NOs: 23, 25, 27, 29, 31, 33, 35, 37, 39, 41, and 88-90 or a variant comprising an amino acid sequence having at least about 80%sequence identity.
  • Embodiment 15 The anti-Sclerostin construct of embodiment 14, wherein:
  • the V H comprises an amino acid sequence of SEQ ID NO: 22, or a variant comprising an amino acid sequence having at least about 80%sequence identity
  • the V L comprises an amino acid sequence of SEQ ID NO: 23, or a variant comprising an amino acid sequence having at least about 80%sequence identity
  • the V H comprises an amino acid sequence of SEQ ID NO: 24, or a variant comprising an amino acid sequence having at least about 80%sequence identity
  • the V L comprises an amino acid sequence of SEQ ID NO: 25, or a variant comprising an amino acid sequence having at least about 80%sequence identity
  • the V H comprises an amino acid sequence of SEQ ID NO: 26, or a variant comprising an amino acid sequence having at least about 80%sequence identity
  • the V L comprises an amino acid sequence of SEQ ID NO: 27, or a variant comprising an amino acid sequence having at least about 80%sequence identity
  • the V H comprises an amino acid sequence of SEQ ID NO: 28, or a variant comprising an amino acid sequence having at least about 80%sequence identity
  • the V L comprises an amino acid sequence of SEQ ID NO: 29, or a variant comprising an amino acid sequence having at least about 80%sequence identity
  • the V H comprises an amino acid sequence of SEQ ID NO: 30, or a variant comprising an amino acid sequence having at least about 80%sequence identity
  • the V L comprises an amino acid sequence of SEQ ID NO: 31, or a variant comprising an amino acid sequence having at least about 80%sequence identity
  • the V H comprises an amino acid sequence of SEQ ID NO: 32, or a variant comprising an amino acid sequence having at least about 80%sequence identity
  • the V L comprises an amino acid sequence of SEQ ID NO: 33, or a variant comprising an amino acid sequence having at least about 80%sequence identity
  • the V H comprises an amino acid sequence of SEQ ID NO: 34, or a variant comprising an amino acid sequence having at least about 80%sequence identity
  • the V L comprises an amino acid sequence of SEQ ID NO: 35, or a variant comprising an amino acid sequence having at least about 80%sequence identity
  • the V H comprises an amino acid sequence of SEQ ID NO: 36, or a variant comprising an amino acid sequence having at least about 80%sequence identity
  • the V L comprises an amino acid sequence of SEQ ID NO: 37, or a variant comprising an amino acid sequence having at least about 80%sequence identity
  • the V H comprises an amino acid sequence of SEQ ID NO: 38, or a variant comprising an amino acid sequence having at least about 80%sequence identity
  • the V L comprises an amino acid sequence of SEQ ID NO: 39, or a variant comprising an amino acid sequence having at least about 80%sequence identity
  • the V H comprises an amino acid sequence of SEQ ID NO: 40, or a variant comprising an amino acid sequence having at least about 80%sequence identity
  • the V L comprises an amino acid sequence of SEQ ID NO: 41, or a variant comprising an amino acid sequence having at least about 80%sequence identity
  • the V H comprises an amino acid sequence of SEQ ID NO: 87, or a variant comprising an amino acid sequence having at least about 80%sequence identity
  • the V L comprises an amino acid sequence of SEQ ID NO: 88, or a variant comprising an amino acid sequence having at least about 80%sequence identity
  • the V H comprises an amino acid sequence of SEQ ID NO: 87, or a variant comprising an amino acid sequence having at least about 80%sequence identity
  • the V L comprises an amino acid sequence of SEQ ID NO: 89, or a variant comprising an amino acid sequence having at least about 80%sequence identity, or
  • the V H comprises an amino acid sequence of SEQ ID NO: 87, or a variant comprising an amino acid sequence having at least about 80%sequence identity
  • the V L comprises an amino acid sequence of SEQ ID NO: 90, or a variant comprising an amino acid sequence having at least about 80%sequence identity.
  • Embodiment 16 An anti-Sclerostin construct comprising an antibody moiety that specifically recognizes Sclerostin, wherein the antibody moiety is a humanized antibody moiety derived from an anti-Sclerostin antibody comprising a heavy chain variable region (V H ) and a second light chain variable region (V L ) , wherein:
  • the V H comprises a HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 1, a HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 5, and a HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 9, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the HC-CDRs;
  • the V L comprises a LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 15, a LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and a LC-CDR3 comprising the amino acid sequence of any one of SEQ ID NOs: 20, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the LC-CDRs;
  • the V H comprises a HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 1, a HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 6, and a HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 10, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the HC-CDRs;
  • the V L comprises a LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 15, a LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and a LC-CDR3 comprising the amino acid sequence of any one of SEQ ID NOs: 20, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the LC-CDRs;
  • the V H comprises a HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 2, a HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 7, and a HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 10, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the HC-CDRs;
  • the V L comprises a LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 15, a LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and a LC-CDR3 comprising the amino acid sequence of any one of SEQ ID NOs: 20, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the LC-CDRs;
  • the V H comprises a HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 3, a HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 6, and a HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 10, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the HC-CDRs;
  • the V L comprises a LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 15, a LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and a LC-CDR3 comprising the amino acid sequence of any one of SEQ ID NOs: 20, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the LC-CDRs;
  • the V H comprises a HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 199, a HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 5, and a HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 10, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the HC-CDRs; and the V L comprises a LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 16, a LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and a LC-CDR3 comprising the amino acid sequence of any one of SEQ ID NOs: 20, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the LC-CDRs;
  • the V H comprises a HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 3, a HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 200, and a HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 10, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the HC-CDRs;
  • the V L comprises a LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 15, a LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and a LC-CDR3 comprising the amino acid sequence of any one of SEQ ID NOs: 20, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the LC-CDRs;
  • the V H comprises a HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 199, a HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 5, and a HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 10, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the HC-CDRs; and the V L comprises a LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 16, a LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 18, and a LC-CDR3 comprising the amino acid sequence of any one of SEQ ID NOs: 20, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the LC-CDRs; or
  • the V H comprises a HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 4, a HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 8, and a HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 11, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the HC-CDRs; and the V L comprises a LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 17, a LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 19, and a LC-CDR3 comprising the amino acid sequence of any one of SEQ ID NOs: 21, or a variant thereof comprising up to 5, 4, 3, 2, or 1 amino acid substitutions in the LC-CDRs.
  • Embodiment 17 The anti-Sclerostin construct of any one of embodiments 1-16, wherein the antibody moiety is an antibody or antigen-binding fragment thereof selected from the group consisting of a full-length antibody, a bispecific antibody, a single-chain Fv (scFv) fragment, a Fab fragment, a Fab’ fragment, a F (ab’) 2, an Fv fragment, a disulfide stabilized Fv fragment (dsFv) , a disulfide stabilized scFv (dsscFv) , a (dsFv) 2, a Fv-Fc fusion, a scFv-Fc fusion, a scFv-Fv fusion, a diabody, a tribody, and a tetrabody.
  • the antibody moiety is an antibody or antigen-binding fragment thereof selected from the group consisting of a full-length antibody, a bispecific antibody, a single-chain Fv (
  • Embodiment 18 The anti-Sclerostin construct of any one of embodiments 1-17, wherein the construct is a full-length antibody comprising an Fc fragment.
  • Embodiment 19 The anti-Sclerostin construct of embodiment 17, wherein the antibody moiety is a scFv fragment.
  • Embodiment 20 The anti-Sclerostin construct of any one of embodiments 1-19, wherein the Sclerostin is a human Sclerostin.
  • Embodiment 21 The anti-Sclerostin construct of any one of embodiments 1-17 and 19-20, wherein the anti-Sclerostin construct further comprises a second moiety.
  • Embodiment 22 The anti-Sclerostin construct of embodiment 21, wherein the second moiety comprises a second antibody moiety that specifically recognizes an antigen.
  • Embodiment 23 The anti-Sclerostin construct of embodiment 22, wherein the second antibody moiety comprises a second heavy chain variable region (V H-2 ) and a light chain variable region (V L-2 ) .
  • Embodiment 24 The anti-Sclerostin construct of embodiment 22 or embodiment 23, wherein the antigen is DKK1.
  • Embodiment 25 The anti-Sclerostin construct of embodiment 24, wherein the DKK1 is a human DKK1.
  • Embodiment 26 The anti-Sclerostin construct of embodiment 24 or embodiment 25, wherein the second antibody moiety competes for a binding epitope of DKK1 with a third antibody moiety comprising a third heavy chain variable region (V H -3) and a third light chain variable region (V L -3) , wherein:
  • V H -3 comprising a HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 42, a HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 43, and a HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 44
  • the V L -3 comprises a LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 45, a LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 46, and a LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 47;
  • the V H -3 comprises a HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 48, a HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 49, and a HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 50
  • the V L -3 comprises a LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 51, a LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 52, and a LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 58;
  • the V H -3 comprises a HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 54, a HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 55, and a HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 56
  • the V L -3 comprises a LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 57, a LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 58, and a LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 59.
  • Embodiment 27 The anti-Sclerostin construct of embodiment 26, wherein V H-2 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 42, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 43, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 44, and the V L-2 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 45, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 46, and the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 47.
  • Embodiment 28 The anti-Sclerostin construct of embodiment 26, wherein the V H-2 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 48, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 49, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 50, and the V L-2 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 51, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 52, and the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 58.
  • Embodiment 29 The anti-Sclerostin construct of embodiment 26, wherein the V H-2 comprising the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 54, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 55, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 56, and the V L-2 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 57, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 58, and the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 59.
  • Embodiment 30 The anti-Sclerostin construct of embodiment 22 or embodiment 23, wherein the antigen is RANKL.
  • Embodiment 31 The anti-Sclerostin construct of embodiment 30, wherein the antigen is human RANKL.
  • Embodiment 32 The anti-Sclerostin construct of embodiment 30 or embodiment 31, wherein the second antibody moiety competes for a binding epitope of RANKL with a third antibody moiety comprising a third heavy chain variable region (V H -3) and a third light chain variable region (V L -3) , wherein the V H -3 comprising a HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 66, a HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 67, and a HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 68, and the V L -3 comprises a LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 69, a LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 70, and a LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 71.
  • V H -3 comprising a HC-CDR1 comprising the amino
  • Embodiment 33 The anti-Sclerostin construct of embodiment 31, wherein the V H-2 comprises the HC-CDR1 comprising the amino acid sequence of SEQ ID NO: 66, the HC-CDR2 comprising the amino acid sequence of SEQ ID NO: 67, and the HC-CDR3 comprising the amino acid sequence of SEQ ID NO: 68, and the V L-2 comprises the LC-CDR1 comprising the amino acid sequence of SEQ ID NO: 69, the LC-CDR2 comprising the amino acid sequence of SEQ ID NO: 70, and the LC-CDR3 comprising the amino acid sequence of SEQ ID NO: 71.
  • Embodiment 34 The anti-Sclerostin construct of any one of embodiments 22-33, wherein the second antibody moiety is a full-length antibody, a Fab, a Fab’, a (Fab’) 2, an Fv, a single chain Fv (scFv) fragment, an scFv-scFv, a minibody, a diabody, or an sdAb.
  • the second antibody moiety is a full-length antibody, a Fab, a Fab’, a (Fab’) 2, an Fv, a single chain Fv (scFv) fragment, an scFv-scFv, a minibody, a diabody, or an sdAb.
  • Embodiment 35 The anti-Sclerostin construct of embodiment 34, wherein the second antibody moiety is a full-length antibody comprising two heavy chains, two light chains and a Fc fragment, and wherein the anti-Sclerostin antibody moiety is a single chain Fv (scFv) fragment comprising the V H fused with the V L .
  • scFv single chain Fv
  • Embodiment 36 The anti-Sclerostin construct of embodiment 35, wherein the anti-Sclerostin antibody moiety is fused to one or both of the heavy chains of the full-length antibody.
  • Embodiment 37 The anti-Sclerostin construct of any one of embodiments 34-36, wherein the anti-Sclerostin antibody moiety is fused to one or both of the light chains of the full-length antibody.
  • Embodiment 38 The anti-Sclerostin construct of embodiment 36 or 37, wherein the anti-Sclerostin antibody moiety is fused to N-terminus of the one or both of the heavy chains or light chains of the full-length antibody.
  • Embodiment 39 The anti-Sclerostin construct of any one of embodiments 36-38, wherein the anti-Sclerostin antibody moiety is fused to C-terminus of the one or both of the heavy chains or light chains of the full-length antibody.
  • Embodiment 40 The anti-Sclerostin construct of any one of embodiments 36-39, wherein the anti-Sclerostin antibody moiety is fused to the full-length antibody via a first linker.
  • Embodiment 41 The anti-Sclerostin construct of any one of embodiments 36-39, wherein the anti-Sclerostin antibody moiety is fused to the full-length antibody without a linker.
  • Embodiment 42 The anti-Sclerostin construct of embodiment 40, wherein the first linker is a GS linker selected from the group consisting of SEQ ID NOs: 74-84.
  • Embodiment 43 The anti-Sclerostin construct of any one of embodiments 35-42, wherein the V H is fused with the V L via a second linker.
  • Embodiment 44 The anti-Sclerostin construct of embodiment 43, wherein the scFv fragment comprises, from N-terminus to C-terminus, the V H , the second linker, and the V L .
  • Embodiment 45 The anti-Sclerostin construct of embodiment 43, wherein the scFv fragment comprises, from N-terminus to C-terminus, the V L , the second linker, and the V H , and optionally a C-terminal alanine residue.
  • Embodiment 46 The anti-Sclerostin construct of any one of embodiments 43-45, wherein the second linker comprises an amino acid sequence of SEQ ID NO: 76 or 77.
  • Embodiment 47 The anti-Sclerostin construct of any one of embodiments 23-33, wherein the second antibody moiety is a scFv fragment comprising the V H-2 and the V L-2 , and wherein the anti-Sclerostin antibody moiety is a full-length antibody comprising two heavy chains, two light chains and a Fc fragment.
  • Embodiment 48 The anti-Sclerostin construct of embodiment 46, wherein the second antibody moiety is fused to both of the heavy chains of the full-length antibody.
  • Embodiment 49 The anti-Sclerostin construct of embodiment 47 or 48, wherein the second antibody moiety is fused to both of the light chains of the full-length antibody.
  • Embodiment 50 The anti-Sclerostin construct of embodiment 48 or 49, wherein the antibody moiety is fused to N-terminus of both of the heavy chains or light chains of the full-length antibody.
  • Embodiment 51 The anti-Sclerostin construct of any one of embodiments 47-50, wherein the antibody moiety is fused to C-terminus of both of the heavy chains or light chains of the full-length antibody.
  • Embodiment 52 The anti-Sclerostin construct of any one of embodiments 47-51, wherein the antibody moiety is fused to the full-length antibody via a first linker.
  • Embodiment 53 The anti-Sclerostin construct of any one of embodiments 47-51, wherein the antibody moiety is fused to the full-length antibody without a linker.
  • Embodiment 54 The anti-Sclerostin construct of embodiment 52, wherein the first linker is a GS first linker selected from the group consisting of SEQ ID NOs: 74-84.
  • Embodiment 55 The anti-Sclerostin construct of any one of embodiments 47-54, wherein the V H-2 is fused with the V L-2 via a second linker.
  • Embodiment 56 The anti-Sclerostin construct of any one of embodiments 47-54, wherein the V H-2 is fused with the V L-2 without a linker.
  • Embodiment 57 The anti-Sclerostin construct of embodiment 55, wherein the scFv fragment comprises, from N-terminus to C-terminus, the V H-2 , the second linker, and the V L-2 .
  • Embodiment 58 The anti-Sclerostin construct of embodiment 55, wherein the scFv fragment comprises, from N-terminus to C-terminus, the V L-2 , the second linker, and the V H-2 , and optionally a C-terminal alanine residue.
  • Embodiment 59 The anti-Sclerostin construct of any one of embodiments 55 and 57-58, wherein the second linker comprises an amino acid sequence of SEQ ID NO: 76 or 77.
  • Embodiment 60 The anti-Sclerostin construct of any one of embodiments 35-59, wherein the scFv is a disulfide stabilized scFv ( “dsscFv” ) .
  • Embodiment 61 The anti-Sclerostin construct of embodiment 60, wherein the dsscFv comprises a) a G44C mutation in the V H or V H-2 according to the numbering of SEQ ID NO: 60, and b) a G100C mutation in the V L or V L-2 according to the numbering of SEQ ID NO: 61.
  • Embodiment 62 The anti-Sclerostin construct of any one of embodiments 35-61, wherein the construct comprises:
  • Embodiment 63 The anti-Sclerostin construct of any one of embodiments 23-33, wherein the construct comprises:
  • a second polypeptide comprising a first heavy chain comprising, from N-terminus to C-terminus, i) the V H , ii) a first heavy chain constant domain ( “first CH1 domain” ) , and iii) a first Fc domain;
  • a third polypeptide comprising a second heavy chain comprising, from N-terminus to C-terminus, i) the V H-2 , ii) a second heavy chain constant domain ( “second CH1 domain” ) , and iii) a second Fc domain;
  • a fourth polypeptide comprising a second light chain comprising, from N-terminus to C-terminus, i) the V L-2 , ii) ii) a second light chain constant domain ( “second CL domain” ) ,
  • first and the second Fc domains form an Fc fragment.
  • Embodiment 64 The anti-Sclerostin construct of embodiment 63, wherein one of the first and the second Fc domains comprises a T366W mutation, and optionally a S354C mutation, and wherein the other Fc domain comprises a T366S mutation, a L368A mutation, a Y407V mutation, and optionally a Y349C mutation, wherein numbering is according to the EU index.
  • Embodiment 65 The anti-Sclerostin construct of embodiment 63 or embodiment 64, wherein either i) the first CH1 domain and the first CL domain or ii) the second CH1 domain and the second CL domain are selected from the group consisting of:
  • a CH1 domain wherein the amino acid at position 141 is substituted for cysteine and the cysteine at position 131 (e.g., in IgG2 or IgG4) or 220 (e.g., in IgG1) is substituted for a non-cysteine amino acid; and a CL domain wherein the amino acid at position 116 is substituted for cysteine and the cysteine at position 214 is substituted for a non-cysteine amino acid;
  • a CH1 domain wherein the amino acid at position 168 is substituted for cysteine and the cysteine at position 131 (e.g., in IgG2 or IgG4) or 220 (e.g., in IgG1) is substituted for a non-cysteine amino acid; and a CL domain wherein the amino acid at position 164 is substituted for cysteine and the cysteine at position 214 is substituted for a non-cysteine amino acid;
  • a CH1 domain wherein the amino acid at position 126 is substituted for cysteine and the cysteine at position 131 (e.g., in IgG2 or IgG4) or 220 (e.g., in IgG1) is substituted for a non-cysteine amino acid; and a CL domain wherein the amino acid at position 121 is substituted for cysteine and the cysteine at position 214 is substituted for a non-cysteine amino acid;
  • a CH1 domain wherein the amino acid at position 128 is substituted for cysteine and the cysteine at position 131 (e.g., in IgG2 or IgG4) or 220 (e.g., in IgG1) is substituted for a non-cysteine amino acid; and a CL domain wherein the amino acid at position 118 is substituted for cysteine and the cysteine at position 214 is substituted for a non-cysteine amino acid;
  • a CH1 domain wherein the amino acid at position 170 is substituted for cysteine and the cysteine at position 131 (e.g., in IgG2 or IgG4) or 220 (e.g., in IgG1) is substituted for a non-cysteine amino acid; and a CL domain wherein the amino acid at position 176 is substituted for cysteine and the cysteine at position 214 is substituted for a non-cysteine amino acid;
  • a CH1 domain wherein the amino acid at position 171 is substituted for cysteine and the cysteine at position 131 (e.g., in IgG2 or IgG4) or 220 (e.g., in IgG1) is substituted for a non-cysteine amino acid; and a CL domain wherein the amino acid at position 162 is substituted for cysteine and the cysteine at position 214 is substituted for a non-cysteine amino acid;
  • a CH1 domain wherein the amino acid at position 173 is substituted for cysteine and the cysteine at position 131 (e.g., in IgG2 or IgG4) or 220 (e.g., in IgG1) is substituted for a non-cysteine amino acid; and a CL domain wherein the amino acid at position 160 is substituted for cysteine and the cysteine at position 214 is substituted for a non-cysteine amino acid;
  • Embodiment 66 The anti-Sclerostin construct of any of embodiments 63-65, comprising:
  • the first polypeptide comprises the amino acid sequence of SEQ ID NO: 135, the second polypeptide comprises the amino acid sequence of SEQ ID NO: 134, the third polypeptide comprises the amino acid sequence of SEQ ID NO: 136, and the fourth polypeptide comprises the amino acid sequence of SEQ ID NO: 137;
  • the first polypeptide comprises the amino acid sequence of SEQ ID NO: 135, the second polypeptide comprises the amino acid sequence of SEQ ID NO: 134, the third polypeptide comprises the amino acid sequence of SEQ ID NO: 138, and the fourth polypeptide comprises the amino acid sequence of SEQ ID NO: 139;
  • the first polypeptide comprises the amino acid sequence of SEQ ID NO: 135, the second polypeptide comprises the amino acid sequence of SEQ ID NO: 134, the third polypeptide comprises the amino acid sequence of SEQ ID NO: 140, and the fourth polypeptide comprises the amino acid sequence of SEQ ID NO: 141;
  • the first polypeptide comprises the amino acid sequence of SEQ ID NO: 135, the second polypeptide comprises the amino acid sequence of SEQ ID NO: 134, the third polypeptide comprises the amino acid sequence of SEQ ID NO: 142, and the fourth polypeptide comprises the amino acid sequence of SEQ ID NO: 143;
  • the first polypeptide comprises the amino acid sequence of SEQ ID NO: 135, the second polypeptide comprises the amino acid sequence of SEQ ID NO: 134, the third polypeptide comprises the amino acid sequence of SEQ ID NO: 144, and the fourth polypeptide comprises the amino acid sequence of SEQ ID NO: 145;
  • the first polypeptide comprises the amino acid sequence of SEQ ID NO: 147
  • the second polypeptide comprises the amino acid sequence of SEQ ID NO: 146
  • the third polypeptide comprises the amino acid sequence of SEQ ID NO: 148
  • the fourth polypeptide comprises the amino acid sequence of SEQ ID NO: 149;
  • the first polypeptide comprises the amino acid sequence of SEQ ID NO: 147
  • the second polypeptide comprises the amino acid sequence of SEQ ID NO: 146
  • the third polypeptide comprises the amino acid sequence of SEQ ID NO: 150
  • the fourth polypeptide comprises the amino acid sequence of SEQ ID NO: 151;
  • the first polypeptide comprises the amino acid sequence of SEQ ID NO: 147
  • the second polypeptide comprises the amino acid sequence of SEQ ID NO: 146
  • the third polypeptide comprises the amino acid sequence of SEQ ID NO: 152
  • the fourth polypeptide comprises the amino acid sequence of SEQ ID NO: 153;
  • the first polypeptide comprises the amino acid sequence of SEQ ID NO: 147
  • the second polypeptide comprises the amino acid sequence of SEQ ID NO: 146
  • the third polypeptide comprises the amino acid sequence of SEQ ID NO: 154
  • the fourth polypeptide comprises the amino acid sequence of SEQ ID NO: 155;
  • the first polypeptide comprises the amino acid sequence of SEQ ID NO: 147
  • the second polypeptide comprises the amino acid sequence of SEQ ID NO: 146
  • the third polypeptide comprises the amino acid sequence of SEQ ID NO: 156
  • the fourth polypeptide comprises the amino acid sequence of SEQ ID NO: 157;
  • the first polypeptide comprises the amino acid sequence of SEQ ID NO: 147
  • the second polypeptide comprises the amino acid sequence of SEQ ID NO: 146
  • the third polypeptide comprises the amino acid sequence of SEQ ID NO: 158
  • the fourth polypeptide comprises the amino acid sequence of SEQ ID NO: 159;
  • the first polypeptide comprises the amino acid sequence of SEQ ID NO: 147
  • the second polypeptide comprises the amino acid sequence of SEQ ID NO: 146
  • the third polypeptide comprises the amino acid sequence of SEQ ID NO: 160
  • the fourth polypeptide comprises the amino acid sequence of SEQ ID NO: 161;
  • the first polypeptide comprises the amino acid sequence of SEQ ID NO: 147
  • the second polypeptide comprises the amino acid sequence of SEQ ID NO: 146
  • the third polypeptide comprises the amino acid sequence of SEQ ID NO: 162
  • the fourth polypeptide comprises the amino acid sequence of SEQ ID NO: 163;
  • the first polypeptide comprises the amino acid sequence of SEQ ID NO: 147
  • the second polypeptide comprises the amino acid sequence of SEQ ID NO: 171
  • the third polypeptide comprises the amino acid sequence of SEQ ID NO: 172
  • the fourth polypeptide comprises the amino acid sequence of SEQ ID NO: 163.
  • the first polypeptide comprises the amino acid sequence of SEQ ID NO: 147
  • the second polypeptide comprises the amino acid sequence of SEQ ID NO: 173
  • the third polypeptide comprises the amino acid sequence of SEQ ID NO: 174
  • the fourth polypeptide comprises the amino acid sequence of SEQ ID NO: 163.
  • the first polypeptide comprises the amino acid sequence of SEQ ID NO: 147
  • the second polypeptide comprises the amino acid sequence of SEQ ID NO: 175
  • the third polypeptide comprises the amino acid sequence of SEQ ID NO: 176
  • the fourth polypeptide comprises the amino acid sequence of SEQ ID NO: 163.
  • Embodiment 67 The anti-Sclerostin construct of embodiment 21, wherein the second moiety comprises a half-life extending moiety.
  • Embodiment 68 The anti-Sclerostin construct of embodiment 67, wherein the half-life extending moiety is an Fc fragment.
  • Embodiment 69 The anti-Sclerostin construct of any one of embodiments 18, and 35-66 and 68, wherein the Fc fragment is selected from the group consisting of Fc fragments form IgG, IgA, IgD, IgE, IgM, and combinations and hybrids thereof.
  • Embodiment 70 The anti-Sclerostin construct of embodiment 69, wherein the Fc fragment is selected from the group consisting of Fc fragments from IgG1, IgG2, IgG3, IgG4, and combinations and hybrids thereof.
  • Embodiment 71 The anti-Sclerostin construct of embodiment 69 or embodiment 70, wherein the Fc fragment comprises a H435R mutation and a Y436F mutation.
  • Embodiment 72 The anti-Sclerostin construct of any of embodiments 69-71, wherein the Fc fragment has a reduced effector function as compared to the corresponding wildtype Fc fragment.
  • Embodiment 73 The anti-Sclerostin construct of any of embodiments 69-71, wherein the Fc fragment has: a) an enhanced effector function as compared to the corresponding wildtype Fc fragment, and/or b) an enhanced FcRn binding affinity as compared to the corresponding wildtype Fc fragment.
  • Embodiment 74 The anti-Sclerostin construct of embodiment 21, wherein the construct is an antibody-drug conjugate or antibody fusion protein.
  • Embodiment 75 The anti-Sclerostin construct of embodiment 74, wherein the second moiety comprises an agent or agents selected from the group consisting of a parathyroid hormone (PTH) , a selective estrogen receptor modulator (SERM) , a bisphosphonate, a prostaglandin E (PGE) receptor agonist, VEGF, TGF ⁇ , growth factor (myostatin) , calcitonin and combinations thereof.
  • PTH parathyroid hormone
  • SERM selective estrogen receptor modulator
  • PGE prostaglandin E
  • VEGF vascular endothelial growth factor
  • TGF ⁇ growth factor
  • myostatin growth factor
  • Embodiment 76 An anti-Sclerostin construct that specifically binds to Sclerostin competitively with the anti-Sclerostin construct of any one of embodiments 1-75.
  • Embodiment 77 A pharmaceutical composition comprising the anti-Sclerostin construct of any one of embodiments 1-76 and a pharmaceutically acceptable carrier.
  • Embodiment 78 The pharmaceutical composition of embodiment 77, wherein the composition further comprises an agent or agents selected from the group consisting of a parathyroid hormone (PTH) , a selective estrogen receptor modulator (SERM) , VEGF, and TGF ⁇ , growth factor (myostatin) , calcitonin and combinations thereof.
  • PTH parathyroid hormone
  • SERM selective estrogen receptor modulator
  • VEGF vascular endothelial growth factor
  • TGF ⁇ growth factor ⁇
  • Embodiment 79 An isolated nucleic acid encoding the anti-Sclerostin construct of any one of embodiments 1-76.
  • Embodiment 80 A vector comprising the isolated nucleic acid of embodiment 79.
  • Embodiment 81 An isolated host cell comprising the isolated nucleic acid of embodiment 79, or the vector of embodiment 80.
  • Embodiment 82 A method of producing an anti-Sclerostin construct comprising:
  • Embodiment 83 A method of treating and/or preventing a disease or condition in an individual, comprising administering to the individual an effective mount of the anti-Sclerostin construct of any one of embodiments 1-76, or the pharmaceutical composition of embodiment 77 or embodiment 78.
  • Embodiment 84 The method of embodiment 83, wherein the disease or condition is a bone-related disorder or cartilage-related disorder, a bone marrow or haemotological disorder, a musculoskeletal rare disease, a muscle-related disorder, or a cancer.
  • Embodiment 85 The method of embodiment 84, wherein the bone-related disorder is osteogenesis imperfecta, osteoporosis or osteopenia (in men and women) , osteonecrosis, delay bone healing, non-union bone fractures, multiple myeloma, multiple myeloma related bone disorders, primary bone tumor, bone metastasis of malignancies, inflammatory or infectious bone disease, osteomalacia, hypercalcemia, Paget’s disease, immobilization-induced bone loss, glucocorticoid-induced bone loss, inflammation-induced bone loss including arthritis-induced bone loss , spaceflight osteoporosis/osteopenia and bone loss caused by reduced gravity or other disease or condition associated with a) bone loss of either quantity or quality or both and/or b) abnormality of bone structure and quality.
  • the bone-related disorder is osteogenesis imperfecta, osteoporosis or osteopenia (in men and women) , osteonecrosis, delay bone healing, non-union bone fractures, multiple mye
  • Embodiment 86 The method of embodiment 85, wherein the bone-related disorder is osteoporosis or osteopenia.
  • Embodiment 87 The method of embodiment 85, wherein the bone-related disorder is osteogenesis imperfecta.
  • Embodiment 88 The method of embodiment 85, wherein the bone-related disorder is multiple myeloma and multiple myeloma related bone disorders.
  • Embodiment 89 The method of embodiment 84, wherein the cartilage disorder is chondromatosis, chondrodysplasia, achondroplasia, epiphyseal dysplasia, chondrodystrophic myotonia, juxtacortical chondroma, tear of cartilage of knee, osteofibrous dysplasia, osteoarthritis, osteogenesis imperfecta, hypophosphatemic rickets or osteochondrodystrophy.
  • the cartilage disorder is chondromatosis, chondrodysplasia, achondroplasia, epiphyseal dysplasia, chondrodystrophic myotonia, juxtacortical chondroma, tear of cartilage of knee, osteofibrous dysplasia, osteoarthritis, osteogenesis imperfecta, hypophosphatemic rickets or osteochondrodystrophy.
  • Embodiment 90 The method of embodiment 84, wherein the muscle-related disorder is sarcopenia and cancer sarcopenia.
  • Embodiment 91 A method of facilitation of heal after bone or joint surgeries in an individual, comprising administering to the individual an effective mount of the anti-Sclerostin construct of any one of embodiments 1-76, and/or the pharmaceutical composition of embodiment 77 or embodiment 78.
  • Embodiment 92 The method of any one of embodiments 83-91, wherein the anti-Sclerostin construct is administered by subcutaneous injection, intravenous injection, intramuscular injection or administered orally or parenterally into the individual.
  • Embodiment 93 The method of any one of embodiments 83-92, wherein the method further comprises administering a second agent or therapy.
  • Embodiment 94 The method of embodiment 93, wherein the second agent or therapy comprises an anti-DKK1 antibody.
  • Embodiment 95 The method of embodiment 93, wherein the second agent or therapy comprises an anti-RANKL antibody.
  • Embodiment 96 The method of embodiment 93, wherein the second agent or therapy comprises an agent selected from the group consisting of a parathyroid hormone (PTH) , a selective estrogen receptor modulator (SERM) , a bisphosphonate, a prostaglandin E (PGE) receptor agonist, VEGF, TGF ⁇ , growth factor (myostatin) and calcitonin.
  • PTH parathyroid hormone
  • SERM selective estrogen receptor modulator
  • PGE prostaglandin E receptor agonist
  • VEGF vascular endothelial growth factor
  • TGF ⁇ growth factor
  • myostatin growth factor
  • Embodiment 97 The method of any one of embodiments 83-96, wherein the individual is a human.
  • the anti-human SOST monoclonal antibody was produced by immunizing mice. Experimental BALB/c mice (18-20g, 7-8 weeks of age, Beijing Vital River Laboratory Animal Technology Co., Ltd. ) and C57 mice (18-20g, 7-8 weeks of age, Beijing Vital River Laboratory Animal Technology Co., Ltd. ) were used. The animals were kept in the SPF level laboratory for 1 week, with 12/12 hours light/dark cycle, at a temperature of 20-25 °C., and humidity of 40-60%.
  • Human SOST recombinant protein with a His tag (HST-H5245, Acro Biosystems) was used as an immunogen.
  • a proprietary adjuvant (Lot No 20200120) was used for emulsification, and the antigen was added with equal volume of adjuvant to reach total volume of 300ul.
  • the antigen/adjuvant solution was emulsified with electro blender and mixed with multi-dimension rotator. After sanitation with 75%alcohol, the antigen/adjuvant solution was injected subcutaneously. The antigen was emulsified and inoculated on days 0, 14, 28.
  • a booster immunization was performed by intraperitoneal (IP) injection of antigen solution formulated with saline at 50 ⁇ g/mouse 3 days prior to splenocyte fusion.
  • IP intraperitoneal
  • a blood titer test was performed on days 22, 36, and 45.
  • two mice with highest blood titer tending to platform were selected for splenocyte fusion.
  • Hybridoma cells were obtained by fusing splenocyte with myeloma Sp2/0 cells by using a conventional fusion procedure with Electro Cell Manipulator (BTX, ECM2001) .
  • the binding activity of mouse serum to human Sclerostin was measured by the ELISA method of Example 3, and the monoclonal hybridoma cell strains with good binding activities in vitro were selected. The results are shown in Table 5.
  • SOP standard operating procedure
  • RACE rapid amplification of cDNA ends
  • Plates were then incubated in blocking solution (PBS containing 1%BSA, 1%goat serum and 0.5%Tween20; 100 ⁇ l/well) for one hour at room temperature (RT) .
  • Anti-Sclerostin antibodies at various concentrations (1000, 333.3, 111.1, 37.0, 12.3, 4.1, 1.4, 0.5, 0.15, 0.05 ng/ml) , a positive control antibody Romosozumab or non-Sclerostin related IgG (human or rat IgG, negative control) , were then added to each well in 20 ⁇ l/well of blocking solution, and plates were incubated at RT for one hour.
  • NeutrAvidin HRP (Pierce, Catalog # 31001) diluted in blocking solution (1: 50,000 dilution) was added at to each well (20 ml/well) , and the plates were incubated at RT for one hour prior to three washes with 100 ml/well of washing solution.
  • SuperSignal ELISA Femto (ThermoFisher Scientific, Catalog# 37074) working solution was added to the plates (20 ml/well) , and the signal was read using a luminometer at 425 nm.
  • the tested anti-Sclerostin antibodies exhibited comparable or more advantageous EC 50 value as compared to that of Romosozumab.
  • 93B1B7 exhibited more advantageous EC 50 value as compared to that of Romosozumab.
  • Antibodies EC 50 (nM) 93B1B7 0.04 94B12D3 0.04 71G6G8 0.04 56E5C10 0.09
  • Antibodies EC 50 (nM) 91F6D10 0.06 51E8D4 0.07 97C11D7 0.04 81B2B6 0.01 84F2D5 0.02 65B12C9 0.04 Romosozumab 0.11
  • Targeting the correct epitope is a critical step in selection of a monoclonal antibody to achieve the desired mechanism of action (Wilson, PC, 2012, Nat. Rev. Immunol. 12, 709–719) .
  • the synthetic peptide-based antibody production against B cell epitopes has been used broadly in developing therapeutic antibodies and vaccines for various diseases in the known art (Ben-Yedidia T., 1997, Curr Opin Bio technol 8: 442–448; Bijker MS, 2007, Expert Rev Vaccines 6: 591–603) , with the specificity advantage of obtained antibodies being restricted to defined epitopes.
  • the second loop on Sclerostin has been proven by NMR and crystallographic structures to interact directly with low-density lipoprotein receptor-related protein family member, e.g., LRP5 or LRP6, and blocks the interaction between LRPs and Wnt family members.
  • LRP5 or LRP6 low-density lipoprotein receptor-related protein family member
  • the loop tip containing the ‘IGRGKWWR’ motif (SEQ ID NO: 186) as shown in FIG. 1 was found to be the main binding determinant for binding of Sclerostin to the first propeller of LRP6.
  • Antibody 93B1B7 binding to chemically synthesized peptides comprising the sequences listed in FIG. 2 from the second loop of human and mouse sclerostin was tested with bio-layer interferometry approach (Gator, Probe Life) .
  • the peptides were biotinylated (NHS-Biotin Reagents, Thermo, #21343) and immobilized on Streptavidin biosensor, using a 0.5 ⁇ g/ml solution.
  • Pep1 SEQ ID NO: 185)
  • pep5 SEQ ID NO: 187)
  • pep6 SEQ ID NO: 188 that have the same ‘IGRGKWWR’ (SEQ ID NO: 186) motif on human Sclerostin were recognized by 93B1B7 with high affinity. In contrast, these peptides cannot be recognized by Romosozumab as show in FIG. 3.
  • Antibody 93B1B7 was humanized by grafting the complementarity determining regions (CDRs) onto human germline frameworks.
  • the light chain germline acceptor sequence chosen was the human VK2 A19 V-region and VK1 O12 V-region plus JK4 J-region (V-BASE, https: //www2. mrc-lmb. cam. ac. uk/vbase/alignments2. php) .
  • the heavy chain germline acceptor sequence chosen was the human VH1 1-18 V-region plus JH4 J-region (V BASE, https: //www2. mrc-lmb. cam. ac. uk/vbase/alignments2. php) .
  • the CDR’s grafted from the donor to the acceptor sequence are as defined by Kabat (Kabat et al. 1987) , with the exception of CDR-H1 and H2 where the combined Chothia/Kabat definition is used.
  • Genes encoding a full-length IgG4P antibody encompassing initial V-region sequences were constructed by an automated synthesis approach (Vanzyme lnc. ) , and modified to generate the final grafted versions by oligonucleotide directed mutagenesis.
  • donor residues at positions 93 (Tyrosine) and 94 (Serine) of the humanized heavy chain (Kabat numbering) were retained, and acceptor residue at position 43 (Glutamine) was changed to Lysine which is more populated at this position.
  • donor residues at position 46 (Arginine) of the humanized light chains (Kabat numbering) were retained.
  • one potential aspartate isomerization site in the light chain CDR L1 was removed by mutating Glycerin residue at position 30 to Serine.
  • Humanized anti-Sclerostin antibodies hAb-1, hAb-2 and hAb-3 were generated. See Table 6 for their CDR, V H and V L sequences.
  • the binding affinity of humanized anti-Sclerostin antibodies to human and cynomolgus monkey Sclerostin were determined with bio-layer interferometry using a Gator instrument (Probe Life) .
  • Antibodies were immobilized on an anti-hFc biosensor, using a 5 ⁇ g solution.
  • Serial dilutions of human Sclerostin and cynomolgus monkey Sclerostin from 4 ⁇ g/ml by two folds in kinetics buffer (PBS, pH 7.4, 0.05%Tween-20, 0.2%BSA, 10 ⁇ M biotin) were used as the analytes.
  • Affinity (K D ) and kinetic parameters (K on and K off ) were calculated from a global fit (1: 1) of the data using the Gator software.
  • Example 7 Sclerostin-neutralization activity of anti-Sclerostin antibodies in HEK293/TCF/LEF/Wnt1 cells
  • the antibodies were capable of neutralizing Sclerostin and blocking Wnt1 induced TCF/LEF luciferase activity, as determined in an HEK293 based assay.
  • the Wnt proteins are a family of secreted glycoproteins that are critical regulators of osteoblast differentiation and activity in both mice and humans.
  • Wnt signals are transduced by a family of seven-pass transmembrane G-protein coupled receptors of the frizzled (Fzd) family, and a co-receptor of the arrow/LRP family, such as LRP5 and LRP6, or a RYK or ROR transmembrane tyrosine kinase.
  • Fzd frizzled
  • LRP5 and LRP6 co-receptor of the arrow/LRP family
  • RYK or ROR transmembrane tyrosine kinase a co-receptor of the arrow/LRP family
  • the binding of a given Wnt to a Fzd receptor and coreceptor activates multiple distinct intracellular signaling cascades, historically divided into the canonical ⁇ -catenin-dependent pathway and noncanonical ⁇ -catenin
  • ⁇ -catenin is an important transcriptional coactivator that regulates gene transcription in response to Wnt signaling.
  • the binding of Wnt to a Fzd receptor complex results in phosphorylation of the LRP5/6 complex, and subsequently stabilizes ⁇ -catenin in cytoplasm.
  • Stabilized ⁇ -catenin is then translocated into the nucleus and interacts with the Lymphoid-enhancing factor/T-cell factor (LEF/TCF) family of high mobility group (HMG) -type transcription factors, to stimulate expression of target genes.
  • LEF/TCF Lymphoid-enhancing factor/T-cell factor
  • HMG high mobility group
  • the cell line HEK293/TCF/LEF/Wnt1
  • Askgene Askgene, CA
  • the inhibitory activities of Wnt signaling antagonists such as Sclerostin and DKK1 were analyzed using this HEK293 cell line expressing a TCF/LEF firefly luciferase reporter gene. Addition of Sclerostin or DKK1 antagonizes the Wnt1 signal, resulting in diminished luciferase activity. Conversely, addition of Sclerostin or DKK1 antibody will block the diminished signal and restore the luciferase activities.
  • cells Upon arrival, cells were cultured in RPMI1640 culture medium with L-glutamine (Life Technologies, CA) , containing 10%fetal bovine serum (FBS) , non-essential amino acids, sodium pyruvate, 2-merceptoethanol, 1%penicillin/streptomycin, 400 ⁇ g/ml G418, and 2 ⁇ g/ml puromycin. Cells were harvested and plated into a white 96-well plate, at a concentration of 30,000 cells/well.
  • FBS fetal bovine serum
  • the culture medium was removed and 50 ⁇ l of assay medium (culture medium without G418 and puromycin) containing 10 mM LiCl, was added into each well.
  • the tested Sclerostin and DKK1 proteins were serial diluted, and equal amount of antagonist was added into the assay plate and incubated for 6 hours at 37 °Cwith 5%CO 2 .
  • 100 ⁇ l/well of One-Step firefly luciferase (Pierce, CA) reagent was added, and the luciferase activity was measured using a BioTek Gen5 luminescence microplate reader (Winooski, VT) .
  • test antibodies When testing the neutralization activities of the antibodies, a serial dilution of the test antibodies and control antibodies was made in assay medium. A fixed amount of either Sclerostin or DKK1 protein was added and incubated for 15 minutes. Then, 50 ⁇ l of the medium was transferred into assay plate, incubated for 6 hours at 37 °C with 5%CO 2 , and analyzed using BioTek Gen5 luminescence microplate reader.
  • results were shown in Table 8 below. As shown, all murine anti-Sclerostin antibodies except 65B12C9 exhibited comparable or more advantageous EC 50 value as compared to that of Romosozumab. The three humanized antibodies, hAb-1, hAb-2 and hAb-3 exhibited more advantageous EC 50 value than that of Romosozumab.
  • Antibodies EC 50 (nM) 93B1B7 57.9 94B12D3 62.8 71G6G8 67.41 56E5C10 64.2 91F6D10 60.58 51E8D4 63.35 97C11D7 55.36 81B2B6 59.61 84F2D5 59.42 65B12C9 152.5 hAb-1 13.89 hAb-2 14.9 hAb-3 15.13 Romosozumab 42.31
  • the humanized anti-SOST antibody hAb-1 and hAb-2 described in this invention and the reference antibody Romosozumab were accessed for precipitation at increasing concentration.
  • the starting concentration was 10 mg/ml in PBS buffer at pH 7.4.
  • the cells were centrifuged at 4 degrees 4000 rpm in an ultrafiltration concentrating tube (Millipore) , and the centrifugation was stopped every 5-10 minutes and the antibody concentration was sampled until the antibody concentration reached 30 mg/ml and 90 mg/ml.
  • the samples were stored at 4°C for 14 days and visually observed for precipitation.
  • the antibodies described in this invention remained clear solution at as high as 90mg/ml, which reference antibody Romosozumab became precipitated and turbid, indicating hAb-1 and hAb-2 are more stable and soluble than Romosozumab in PBS buffer at pH7.4. This result suggests that the antibodies described in this invent can be stable in high concentration formulations like 90mg/ml.
  • Bispecific antibodies that target both Sclerostin and DKK1 or RANKL were generated. See Tables 9 and 10 for sequences of the exemplary antibodies that target DKK1 or RANKL.
  • HC-CDR1 GFTFSSYAMS SEQ ID NO: 66
  • HC-CDR2 GITGSGGSTYYADSVKG SEQ ID NO: 67
  • HC-CDR3 DPGTTVIMSWFDP SEQ ID NO: 68
  • LC-CDR1 RASQSVRGRYLA SEQ ID NO: 69
  • LC-CDR2 GASSRAT SEQ ID NO: 70
  • LC-CDR3 QQYGSSPRT SEQ ID NO: 71
  • anti-DKK1 11H10-V H 44V L 32 (or anti-RANKL Denosumab) Fv domain was transformed into scFvs with two different orientations of V H and V L , linked by a (GGGGS) 4 linker. There are mutations like G100C in V H and G44C in V L to facilitate correct assembly of scFvs.
  • Two anti-DKK1 (or anti-RANKL) scFvs are linked to each of two IgG heavy chain C-termini of anti-Sclerostin humanized antibodies respectively by one GGGGSGGGGSGGGGS (SEQ ID NO: 76) linker to form bispecific of IgG-scFv.
  • anti-Sclerostin antibodies and anti-DKK1 11H10-V H 44V L 32 were transformed into ‘Knob-into-Hole’ bispecific antibodies with asymmetric IgG structure.
  • the CL domain of anti-DKK1 11H10-V H 44V L 32 contains mutations of S176C and C214S, and the CH1 domain contains mutations like F170C and C131S to form orthogonal CH 1 -CK disulfide bond to enable light chains correct paring.
  • Table 11 lists format and sequences of various anti-Sclerostin bispecific antibodies.
  • Bispecific molecules were transiently expressed in adherence-adapted 293 6E cells in 96-well plates.
  • Adherent 293 6E cells were seeded in Poly-D-Lysine coated 96-well tissue culture plates at 5E4 cells per well in Serum-free KOP293 medium (Zhuhai Kairui Biotech #K03252) at 25 ⁇ g/ml, and 5%FBS 24 hours prior to the transfection and incubated overnight at 37 °C in 5%CO 2 .
  • 100 ng (40 ng/ ⁇ l) of each corresponding HC and LC DNA of the binding molecules were mixed together.
  • Serum-free media KOP293 25 ⁇ l/well was added to the DNA mixtures.
  • CM Conditioned media
  • Antibodies were purified by protein A affinity chromatography, and buffer exchanged in PBS (pH 7.2) . The concentrations of purified antibodies were determined by reading the absorbance at 280 nm using the theoretically determined extinction coefficient for that protein.
  • Example 10 The binding kinetics and affinities of anti-Sclerostin ⁇ anti-DKK1 and anti-Sclerostin ⁇ anti-RANKL bispecific antibodies
  • Binding kinetics and affinities of anti-Sclerostin x anti-DKK1 and anti-Sclerostin x anti-RANKL bispecific antibodies were measured with Gator (Probe Life) bio-layer interferometry (BLI) .
  • Antibodies were immobilized on an anti-hFc biosensor, using a 5 ⁇ g/ml solution.
  • Serial dilutions of sclerostin (from 1 ⁇ g/ml) , DKK1 (from 2 ⁇ g/ml) , or RANKL (from 4 ⁇ g/ml) by two folds in kinetics buffer (PBS, pH 7.4, 0.05%Tween-20, 0.2%BSA) were used as the analytes.
  • Affinity (K D ) and kinetic parameters (K on and K off ) were calculated from a global fit (1: 1) of the data using the Gator software. The results are summarized in Table 12.
  • the affinity K D values are calculated by K off /K on , in the case that K off is LOD, the K D values are estimated around 10pM, which is the detection limit of Gator
  • the WNT signaling assays were performed as described in Example 7, where 1 ⁇ g/ml human Sclerostin and DKK1 were added separately. All bsAbs were able to fully neutralize Wnt-antagonizing effect from both sclerostin and DKK1 in a dose dependent manner.
  • the EC 50 activities as shown in Table 13.
  • the assay for the determination of bsAbs in cynomolgus monkey serum employed a qualified fit-for-purpose sandwich ELISA method.
  • CORNING High binding 96 well polystyrene Microplates were coated with a specific human IgG-heavy and light chain monkey-adsorbed Antibody. Standard, quality control and unknown samples were loaded into the wells, and any human antibody present was bound by the immobilized antibody. After washing away any unbound substances, a human IgG-heavy and light chain monkey-adsorbed Antibody Conjugate HRP and TMB Substrate Solution for ELISA were added to the wells. Only the samples that contain human bsAbs bound to both the capture and detection antibody produced absorption signal at 450 nm. The signal produced was proportional to the amount of human bsAb present. The lowest quantifiable concentration (LLOQ) of antibodies in a sample was 0.1 ⁇ g/ml.
  • the bone formation biomarker procollagen type I N-terminal propeptide (P1NP) as well as bone resorption biomarker C-terminal end of the telopeptide of type I collagen (CTX-1) are two widely accepted specific bone homeostatic indicators.
  • P1NP bone formation biomarker procollagen type I N-terminal propeptide
  • CTX-1 bone resorption biomarker C-terminal end of the telopeptide of type I collagen
  • Example 15 Bispecific antibodies are able to prevent bone fractures in osteogenesis imperfecta (OI)
  • the multiscale hierarchical structure of bone is naturally optimized to resist fractures. Enhanced bone formation and reduced bone absorption are two important process to keep the bone strength strong and healthy.
  • osteogenesis imperfecta or brittle bone disease
  • genetic mutations affect the quality and/or the quantity of collagen and dramatically increased bone fracture risk.
  • the treatment to reduce the fracture rates in OI is the ultimate goal for clinical improvement. Therefore, we investigated the bispecific antibodies in osteogenesis imperfecta (OI) mouse model (oim/oim) where a spontaneous mutation in the pro-a2 chain of type I collagen causes poor bone quality and lower bone mass resulted in frequent brittle bone fractures.
  • the bispecific antibodies are also evaluated in RPMI8226 human multiple myeloma (MM) cells.
  • MM multiple myeloma
  • DKK1 expression levels are increased in MM patients and are associated with the severity of the disease (Fulciniti M. et al. Blood, 2009; 114 (2) : 371-379., Feng Y et al. Cancer Biomarkers. 2018; 1: 1-7) .
  • studies have shown that about 80-90%of MM patients develop MM related bone disorder (MMBD) .
  • the major clinical expression of MMBD is osteolytic lesions and fractures due to increased activities of bone resorption and suppression of bone formation.
  • the nature of the bispecific antibodies will benefit MMBD patients by providing bone resorptive inhibition as well as by inhibiting DKK1 expression that leads to increase bone formation.
  • Our preliminary studies demonstrated that in vitro cell culture of MM cells (RPMI 8226) subjected to the molecule showed a decrease in cell surface marker CD138 levels, suggesting the cells might be undergone apoptosis process.
  • CCK8 analysis of tumor growth showed a dose dependent reduction in tumor cell numbers.
  • the bispecific antibody could cause the RPMI8226 MM cells apoptosis and arrested the tumor cell growth.
  • the results suggested the therapeutic application to treat MMBD and tumor metastatic related bone disorders by not only preventing bone disorders (as data shown in Example 14 and 15) but also directly inhibiting tumor growth.

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EP21871631.4A 2020-09-28 2021-09-26 Anti-sclerostin constructs and uses thereof Pending EP4217389A1 (en)

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